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Biomedical subjects

J E Ferguson

Publications and source records attributed to J E Ferguson.

103 records · Page 6Linked to original sources
PubMed1985

Hemoglobin E and pregnancy.

Hemoglobin E occurs in 30 million people, primarily Southeast Asians. Their resettlement within the US has dramatically increased the incidence of E hemoglobinopathies. A gravid Vietnamese woman with thalassemia major is reported herein. Her pregnancy was complicated by severe anemia, intrauterine growth retardation, and a paraspinal mass representing extramedullary hematopoiesis. The diagnosis of hemoglobin E/beta o-thalassemia was established when analysis of her hemoglobin showed 60% F, 40% E, and 0% A. The patient was transfused with packed red blood cells to maintain the maternal hematocrit at 30%. A term growth-retarded infant was delivered who had severe thrombocytopenia and an imperforate anus. The infant's thrombocytopenia responded only to infusion of maternal platelets. The differential diagnosis and expected hematologic manifestations of the various E hemoglobinopathies are detailed. Hematologic and obstetric guidelines for management during pregnancy are offered.

Adult↗
PubMed1984

Adjunctive use of magnesium sulfate with ritodrine for preterm labor tocolysis.

The purpose of the study was to determine if the adjunctive administration of magnesium sulfate with ritodrine would result in decreased dosage requirements of ritodrine, and, therefore, decrease the incidence of ritodrine-associated side effects. Candidates for tocolysis were prospectively randomized so that some received a uniform tocolytic dose of magnesium sulfate in a blinded protocol. All patients received a ritodrine infusion which was titrated in the standard manner to achieve cessation of labor. Evaluations included interval cumulative ritodrine dose, maximal ritodrine infusion rate, fluid balance, and blood chemistry studies. Contrary to our hypothesis, there were significantly more cardiovascular effects in the group that received ritodrine plus magnesium sulfate (11/24) than in the group that received ritodrine alone (1/17) (p less than or equal to 0.02). The predominant side effect was chest pain, frequently associated with electrocardiogram changes indicative of myocardial ischemia. These results are consistent with the current understanding of the regulatory mechanisms of these tocolytic agents. We conclude from the results of our prospective, randomized, blinded study that the adjunctive use of magnesium sulfate with ritodrine is associated with an unacceptable increase in serious side effects and probably does not improve efficacy.

Adult↗
PubMed1984

Acute leukemia and pregnancy: a review of management and outcome, 1972-1982.

Acute leukemia is a rare complication of pregnancy. Previous reviews that covered cases reported before the introduction of effective combination chemotherapy found fewer than 300 reported pregnancies, with a 36-69 per cent perinatal mortality and median maternal survival, from diagnosis, of less than 6 months. Advances in the fields of hematology-oncology, maternal-fetal medicine, and neonatology have resulted in a marked improvement in both perinatal survival statistics, and median maternal survival. Since 1972, there have been 14 pregnancies reported in patients cured of acute lymphocytic leukemia, with 1 early spontaneous abortion and 13 term infants. All mothers survived. There have been 47 reports of pregnancy in association with acute leukemia. In 40 pregnancies in which acute leukemia was treated, there were 5 abortions, 3 perinatal demises, 1 infant "liveborn in grave condition," and 31 surviving infants. Median maternal survival was at least 6, and possibly more than 12 months from delivery. In seven cases in which leukemia was untreated, there were one abortion, two perinatal demises, and four living infants; only one of six mothers survived beyond 6 months. Here, a case of pregnancy complicated by acute promyelocytic leukemia is presented. The mother was aggressively treated with combination chemotherapy. The fetus was closely monitored and delivered following a course of betamethasone at 34 weeks' gestation, and had no neonatal problems. The mother expired 13 months status-post bone marrow transplantation, 16 months after delivery. Cases of pregnancy complicated by acute leukemia reported in the period 1972-1982 are reviewed, and management is discussed in detail. Aggressive hematologic and obstetric management is advocated, and should result in further improvements in fetal and maternal outcome.

Acute Disease↗
PubMed1983

Marfan's syndrome: acute aortic dissection during labor, resulting in fetal distress and cesarean section, followed by successful surgical repair.

A unique case of Marfan's syndrome is presented in which the diagnosis was first established during early labor when the patient presented with chest pain, hypotension, and fetal distress as the earliest symptoms and signs. Prompt diagnosis in combination with correct medical and surgical therapy resulted in the survival of both the mother and infant.

Acute Disease↗
PubMed1983

Polycythemia rubra vera and pregnancy.

Polycythemia rubra vera is a rare complication of pregnancy. Only 13 pregnancies occurring in eight women have been reported. The maternal outcome is uniformly good except for an apparent association of pregnancy-induced hypertension. The perinatal outcome is poor and is due to the frequent occurrence of abortion, preterm delivery, and stillbirth. The etiology of the disease is discussed along with symptoms and diagnostic criteria. A young woman who successfully negotiated two pregnancies is presented. Guidelines for hematologic monitoring and management during pregnancy and the early puerperium are proposed.

Adolescent↗
PubMed1979

Analysis of Endosperm Sugars in a Sweet Corn Inbred (Illinois 677a) Which Contains the Sugary Enhancer (se) Gene and Comparison of se with Other Corn Genotypes.

The endosperm sugars of a new corn (Zea mays L.) mutant, sugary enhancer (se), were analyzed by gas-liquid chromatography and were compared with sugars of other genotypes. Illinois 677a, a sugary (su) inbred containing the se gene, was high in sucrose and was distinguished from all of the other genotypes by its high maltose content. During kernel development, the maltose content of IL677a increased to 3.28% dry weight at 40 days postpollination and remained high at the dry mature stage, whereas ;Silver Queen,' a high quality sugary (su) hybrid not possessing the se gene, showed no such trend in maltose accumulation. Sucrose, fructose, and glucose decreased during kernel development in ;Silver Queen' and IL677a from 19 days postpollination until the dry mature stage. The slow drying characteristic and the reduced starch content previously reported for maturing seeds of IL677a may be related to the maltose accumulation reported here.

Journal Article↗
PubMedDate not supplied

Parathyroid hormone-related protein mRNA in sheep endometrium and myometrium during late gestation and labor.

OBJECTIVE: To determine quantitative changes of parathyroid hormone-related protein (PTHrP) mRNA in sheep myometrium and endometrium during late gestation and labor. METHODS: Tissues were obtained from 22 pregnant ewes under halothane anesthesia: early controls at 131 days' gestational age (dGA) not in labor (ECNL; n = 6); during cortisol-induced premature labor (CPL at 131 dGA; n = 6); in term spontaneous labor (STL at 140-145 dGA; n = 5); or term control animals not in labor (TCNL at 140-145 dGA; n = 5). Total RNA was extracted and subjected to Northern blot analysis. Blots were probed with a human PTHrP cDNA probe, stripped, and rehybridized with an 18s rRNA nucleotide probe to normalize PTHrP mRNA levels. RESULTS: Endometrial PTHrP mRNA:18s was unaffected by gestational age or labor in tissues from the four groups. In contrast, myometrial PTHrP mRNA:18s ratio was decreased when TCNL and STL were compared with both ECNL and CPL groups (P < .05). CONCLUSIONS: Significant changes occur at the end of gestation in pregnant ovine myometrium PTHrP mRNA but not in the endometrium. In myometrium PTHrP mRNA levels were down-regulated at term regardless of whether labor was present. It seems that PTHrP mRNA levels in myometrium are related to gestational age rather than to labor per se in sheep. We hypothesize that PTHrP may play a role in maintaining uterine quiescence until term, at which time levels fall allowing myometrial contractile activity to increase unopposed by PTHrP.

Animals↗
PubMedDate not supplied

Transporting the incubator: effects upon a region of the adoption of guidelines for high-risk maternal transport.

OBJECTIVE: To inventory maternal transport practices and develop regional transport guidelines. STUDY DESIGN: A survey was administered to perinatal nursing directors of nine community hospitals in a rural region of Virginia. Items included personnel, training, equipment, vehicle, communication, and protocols. Following the survey, regional guidelines were developed using a collaborative process. Their use was promoted in the region. A post-intervention survey documented changes in transport practices. RESULTS: The pre-intervention survey showed wide variability in training and number of personnel and in availability of emergency equipment. Communication was via radio to a dispatcher. No hospital had standing orders or protocols for transport. Guidelines were developed, which included recommendations for personnel, equipment, vehicle, communication methods, and care protocols. Eight of nine hospitals endorsed the guidelines. A follow-up survey revealed practice changes for standing orders/protocols, communication, and equipment. CONCLUSION: Regionwide practice changes can be successfully implemented. Guidelines may be helpful for other regions using primarily one-way maternal transports.

Emergency Medical Service Communication Systems↗
PubMedDate not supplied

Break the cycle: the role of cell-cycle modulation in the prevention of vasculoproliferative diseases.

Atherosclerosis is a major health problem in the western world, and the effectiveness of interventional therapeutic modalities for symptomatic atherosclerotic lesions is limited by vessel restenosis. Proliferation and migration of smooth muscle cells (SMCs) play a central role in post-interventional restenosis. Accordingly, many therapeutic approaches attempt to inhibit SMC proliferation. As the cell cycle is a final common pathway in SMC proliferation, proteins of the cell cycle have emerged as logical targets for the treatment and prevention of restenotic lesions. In this review we discuss current approaches that target the cell cycle in smooth muscle cells, and also describe recent and ongoing clinical trials that involve cell-cycle manipulation in the treatment of vasculoproliferative diseases.

Animals↗