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Biomedical subjects

J M Bowman

Publications and source records attributed to J M Bowman.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1990

Intrauterine transfusion--intraperitoneal versus intravascular approach: a case-control comparison.

Intravascular fetal transfusion has gained widespread acceptance and has supplanted the use of intraperitoneal fetal transfusion in management of severe alloimmune disease in many centers. This study compares the two methods with regard to multiple objective end points of performance, therapy, and outcome in a highly matched case-control fashion. The intravascular approach is better on almost every level. More surviving infants who are in better condition at a mature gestation and whose mothers have fewer complications and sequelae are the result. Whereas intraperitoneal transfusion should not be abandoned altogether, it is a second-line procedure used only in very limited circumstances. Intravascular fetal transfusion offers realistic prognosis for intact survival at virtually any extreme of alloimmune disease.

Blood Group Incompatibility↗
PubMed1990

Anti-Rh(D) IgG subclasses and severity of Rh hemolytic disease of the newborn.

The influence of anti-Rh(D) IgG subclasses on the severity of hemolytic disease of the newborn was examined in 98 pregnancies. Disease was severe in 19 of 32 cases in which only IgG1 was detected, 40 of 63 cases in which IgG1 and IgG3 were found and 0 of 3 cases in which only IgG3 was detected. When both IgG1 and IgG3 anti-D were present, hemolytic disease was more severe than when IgG1 alone was detected. The earliest onset of hydrops was at 20 weeks gestation in the IgG1 + IgG3 anti-Rh group, and at 27 weeks gestation in the IgG1 group.

Erythroblastosis, Fetal↗
PubMed1989

Intravenous human rabies immunoglobulin for post-exposure prophylaxis: serum rabies neutralizing antibody concentrations and side-effects.

The beneficial effect of passive immunization for post-exposure rabies prophylaxis is associated with the appearance of serum neutralizing antibody (SNA) earlier than occurs with vaccine alone. We compared the SNA response and the side-effects in 30 previously unimmunized healthy volunteers given a commercially available human rabies immunoglobulin (HRIG) intramuscularly (i.m.) or an experimental HRIG prepared by DEAE Sephadex column chromatography, intravenously (i.v.) with or without human diploid-cell culture rabies vaccine (HDCS). The subjects were divided into five equal groups: HDCS alone, HDCS + i.m. HRIG 20 IU/kg (currently recommended), i.v. HRIG alone 15 IU/kg, HDCS + i.v. HRIG 15 IU/kg or HDCS + HRIG 5 IU/kg i.v. plus 10 IU/kg i.m. to simulate local bite wound infiltration. HDCS, 1.0 ml, was injected subcutaneously (s.c.) on days 0, 3, 7, 14 and 28. Only local discomfort at injection sites was observed without differences between groups. SNA was demonstrated in all HRIG recipients at day 1, but the concentrations were higher in those receiving it intravenously. No difference in the SNA response to vaccine was observed between the i.v. and i.m. HRIG groups given the same vaccine lot. It would appear that i.v. HRIG 15 IU/kg can be substituted for i.m. HRIG 20 IU/kg for post-exposure prophylaxis. Since the current regimen is almost 100% protective, there is no way of proving that i.v. HRIG 15 IU/kg is more efficacious. The immediate SNA level and economy are the chief advantages of i.v. HRIG 15 IU/kg.

Antibodies, Viral↗
PubMed1989

Erythroblastosis fetalis produced by anti-k.

We report an instance of transfusion-induced anti-k so severe that three intrauterine intravascular fetal transfusions were required. The pretransfusion circulating hemoglobin level in the fetus was 60 g/l and hematocrit was 0.19. This, to our knowledge, is the first example of the rare alloantibody, anti-k, producing erythroblastosis so severe that fetal transfusions were required in order to prevent hydrops fetalis from developing. Anti-k alloimmunization, which in a period of 20 years and 8 months occurred only once in 3,246 alloimmunized pregnancies in Manitoba, can cause severe fetal disease. The k-alloimmunized pregnant woman should be managed in the same manner as the D-, c-, or K-alloimmunized pregnant woman.

Adult↗
PubMed1989

Current technique of intraperitoneal transfusion: do not throw away the renografin.

The original description of intraperitoneal transfusion calls for contrast-dye infusion and X-ray confirmation of placement of the needle free in the peritoneal cavity. Ultrasound methods, using air or saline as contrast media, have been described to replace the X-rays. This report illustrates at least one way in which the ultrasound findings at intraperitoneal transfusion may be illusory, allowing misplaced transfusion into the fetal colon. In specific instances, use of radiopaque dye at intraperitoneal transfusion may still be helpful.

Adult↗
PubMed1988

Gingival overgrowth induced by diltiazem. A case report.

Gingival overgrowth induced by diphenylhydantoin (Dilantin) has been well documented in the literature. Recently, there have been other medications with side effects causing Dilantin-like gingival overgrowth. This article presents a case in which diltiazem (Cardizem), a calcium-channel blocker, induced gingival overgrowth. A discussion of the clinical and histologic features and possible pathogenesis of the disorder is presented.

Aged↗
PubMed1988

Response of dairy cows in early lactation to sodium hydroxide-treated soybean meal.

To determine effects of protein and rumen degradability in rations for early lactation cows, four diets (44:56 roughage:concentrate) were formulated to contain 15 or 17.5% CP and supplemental protein from untreated or NaOH-treated soybean meal. Diets were allocated to 34 multiparous Holstein cows from d 22 to 91 of lactation. Treatment means adjusted by covariance using data from d 10 to 21 for average daily milk (kg), milk fat (%), milk protein (%), and SCM (kg) were: 15% untreated 32.9, 3.54, 3.16, and 31.3; 15% NaOH-treated 31.1, 3.59, 3.08, and 29.6; 17.5% untreated 32.2, 3.70, 3.30, and 31.2; and 17.5% NaOH-treated 32.6, 3.58, 3.17, and 30.8. Increasing dietary protein percent raised milk protein percent but not protein yield or yield of other milk components, milk yield, SCM yield, or DM intake. Protein source had no effect on production or feed intake. Decreasing dietary protein percentage and use of NaOH-treated soybean meal reduced rumen ammonia. Degradation of protein in feeds was determined in four rumen fistulated lactating cows. Sodium hydroxide treatment of soybean meal reduced protein degradation in situ.

Animal Feed↗
PubMed1987

Failures of intravenous Rh immune globulin prophylaxis: an analysis of the reasons for such failures.

Universal administration of an ion exchange column prepared Rh immune globulin (RhIG-IV) antepartum at 28 weeks' gestation and postpartum to 9,295 Rh negative women delivering Rh positive babies has reduced the prevalence of Rh immunization from the expected 601 to 25 (a protection rate of 95.9%). Rh immunization, despite universal Rh prophylaxis, developed in 25 women; eight before antenatal prophylaxis was administered, 17 after antenatal prophylaxis was administered. Residual Rh immunization is caused by small fetal transplacental hemorrhages (TPH) (greater than or equal to 0.01 mL of fetal blood) before antenatal prophylaxis (15%) and by significant fetal TPH (greater than or equal to 0.05 mL of fetal blood) between 30 and 38 weeks' gestation (18%); TPH was too great, in some instances, for residual passive Rh antibody to give protection. Although a reduction of 62% (five of eight) of early Rh immunization and 82% (14 of 17) of later Rh immunization might be achieved by addition of 16 weeks' to 20 weeks' gestation and 34 weeks' gestation Rh prophylaxis; and a reduction of 84% overall (21 of 25) might be achieved by universal fetal TPH screening every 2 weeks from 10 weeks' gestation until delivery, with administration of RhIG when a small early fetal TPH or a significant later fetal TPH is detected, all of these programs are costly in terms of prevention of perinatal mortality and in terms of cost per quality adjusted life year gained. We believe that the costs outweigh the benefit that would be achieved. Therefore, a residual Rh immunization prevalence of 0.24% to 0.31% during or after each Rh positive pregnancy in patients at risk is to be expected despite universal 28 weeks' gestation antenatal and postnatal Rh prophylaxis.

Female↗