PubMed Health⌕ Search

Biomedical subjects

J Dowd

Publications and source records attributed to J Dowd.

At least 19 recordsLinked to original sources
PubMed2001

Is there an interaction between cervical length and cervical microbiology in the pathogenesis of preterm labour?

Transvaginal ultrasound of the cervix is increasingly used to estimate cervical length during pregnancy. Initially used to determine a possible need for cervical suture, the technique has been shown to be of value in the prediction of preterm delivery In addition, bacterial vaginosis has been shown to be associated with an increased risk of preterm delivery. We hypothesised that shortening of the cervix and potential cervical pathogens, in particular the presence of bacterial vaginosis, act synergistically in the pathogenesis of premature labour. Three hundred and sixteen women were recruited for prospective longitudinal follow-up, with both transvaginal ultrasound and cervical bacteriology performed at approximately 18 and 28 weeks gestation. A strong correlation was found between a shortened cervix and preterm delivery (p<0.02 at 18 weeks; p<0.001 at 28 weeks). Women with both a short cervix and cervical pathogens had the highest risk of preterm delivery (43%), although not significantly greater than a short cervix with normal cervical flora (31% preterm delivery). In the presence of a normal cervical length, preterm delivery rates in the presence of normal flora and potential cervical pathogens were much lower (9% and 5% respectively).

Cervix Uteri↗
PubMed2001

Elevated interleukin-8 concentrations in cervical secretions are associated with preterm labour.

The aim of this study was to assess the potential clinical utility of interleukin-8 (IL-8) present in cervical secretions as a marker of preterm labour and delivery. Samples of cervical mucus from 91 pregnant women were assessed for the presence and concentration of IL-8. Two samples were collected (at 18 +/- 2 and 28 +/- 2.5 weeks of gestation) and correlated with cervicovaginal microbiology and cervical length, as measured by transvaginal ultrasound. The IL-8 concentration at 28/40 was significantly higher in women who went on to deliver preterm (p < 0.01), and there was a greater than five-fold increase from 18 to 28 weeks in 6/7 of these women.

Cervix Mucus↗
PubMed1999

Ischemic colitis associated with pseudoephedrine: four cases.

OBJECTIVE: There is one previously reported case linking ischemic colitis and orally administered nasal decongestants containing pseudoephedrine (MEDLINE 1974-1998). We aimed to document an association between pseudoephedrine ingestion and ischemic colitis. METHODS: We reviewed the cases of four women (ages, 37-50 yr) who presented with the sudden onset of colicky abdominal pain followed by hematochezia. Three patients had used medicine containing pseudoephedrine daily for approximately 1 wk before admission. The fourth patient had used pseudoephedrine chronically for 6 months. Two patients had no significant past medical history. One woman had presented 6 months earlier with ischemic colitis while taking both pseudoephedrine and hormone replacement therapy. This time she presented with ischemic colitis while not taking hormone replacement therapy, but still taking decongestants. Another woman had a history of ulcerative colitis, which had been quiescent for 10 yr. One patient had been a smoker; however, like the other patients she had no evidence of systemic vascular disease. On colonoscopy, all four patients had colitis, primarily affecting the splenic flexure in the anatomical watershed area. Other causes of segmental colitis, including infectious colitides, pseudomembranous colitis, and Crohn's disease, were not evident. Colonoscopic biopsies were consistent with ischemic injury. RESULTS: All cases responded to abstinence from pseudoephedrine and medical supportive therapy. None has had a relapse since discontinuing the pseudoephedrine (8-12 months). CONCLUSIONS: The vasoconstrictive action of pseudoephedrine may predispose susceptible patients to develop ischemic colitis in the watershed area of the splenic flexure. Perimenopausal women may be especially susceptible because of irregular ovulation. This may result in relative vasoconstriction when estrogen levels are low or a hypercoagulable state when estrogen levels are excessive.

Adult↗
PubMed1992

Pregnancy outcome following preterm premature rupture of the membranes at less than 26 weeks' gestation.

The outcome of 71 singleton pregnancies where premature rupture of the membranes (PROM) occurred at gestations of less than 26 weeks was assessed retrospectively. The incidence of chorioamnionitis was 39.4% and the overall maternal morbidity rate was 53% but there were no long-term maternal sequelae. The latent period from PROM until delivery ranged from less than 12 hours to 77 days, with 41% of women delivering within 1 week. There was no increased risk of infection with increasing latent period. The perinatal mortality was 66.2% (26.7% stillbirths and 39.4% neonatal deaths). There was a 65% chance of a live baby if PROM occurred between 24-26 weeks but only 5 of 40 fetuses (12.5%) survived if PROM occurred before 24 weeks. The use of antibiotics, tocolytics and steroids in an uncontrolled manner is reported. Overall there is little serious risk to the mother if a conservative approach is adopted but only about one-third of such women will take home a live baby.

Chorioamnionitis↗
PubMed1986

In vitro inhibition of interleukin-2 production by peripheral blood lymphocytes from stage III melanoma patients by prostaglandin E2: enhancement of lymphocyte proliferation by exogenous interleukin-2 plus indomethacin.

Interleukin-2 (IL-2) production following concanavalin A stimulation and the response of peripheral blood mononuclear cells (PBMC) to both IL-2 alone and IL-2 plus indomethacin, a prostaglandin synthetase inhibitor, were examined in 16 melanoma patients and 12 healthy controls. Mean IL-2 production by PBMC in 11 melanoma patients with metastatic disease (Stage III) was significantly decreased compared with controls and was moderately decreased compared with five patients with resected nodal disease (Stage II). Indomethacin restored IL-2 production in Stage III PBMC to levels equivalent to that produced by control PBMC. The PBMC of stage III patients also produced 40 times more prostaglandin E2 than PBMC from controls or Stage II patients. Indomethacin plus IL-2, but not IL-2 alone, was capable of restoring the low blastogenic response of PBMC of Stage III patients to normal levels. Hence, these data emphasize the importance for using IL-2 along with indomethacin for in vivo immunorestoration in disseminated melanoma.

Concanavalin A↗