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Biomedical subjects

D I Phillips

Publications and source records attributed to D I Phillips.

At least 109 records · Page 6Linked to original sources
PubMed1988

Iodine supplementation: comparison of oral or intramuscular iodized oil with oral potassium iodide. A controlled trial in Zaire.

A community-based controlled trial of iodine supplementation comparing oral or intramuscular iodized oil with oral potassium iodide has been carried out in 23 severely iodine-deficient villages in Eastern Zaire. The overall goitre prevalence in the population (n = 5999) was 61% and mean urinary iodine excretion in sample of 57 women 10.9 (SD 6.8) micrograms/g creatinine. All adults in three groups of four villages were given single doses of potassium iodide of 0.5 g, 1.0 g, and 2.0 g respectively. A fourth group was given oral iodized oil (2 ml) and a fifth placebo-treated. A further three villages were given intramuscular iodized oil (2 ml). The effectiveness of supplementation was assessed by measurements of bloodspot thyroxine (T4) concentration in women of reproductive age in the villages. The effects of iodide were small and inconsistent. Eight months after supplementation with oral iodized oil the distribution of T4 concentrations was similar to that seen with intramuscular oil. We conclude that oral iodized oil is an effective alternative to injected oil and would be feasible for iodine supplementation in remote areas with untrained people.

Administration, Oral↗
PubMed1988

Carotid sinus hypersensitivity and complete heart block in Reiter's syndrome.

We describe a 42-year-old man with Reiter's syndrome who developed complete heart block only 5 weeks after the onset of his illness. He was also noted to have carotid sinus hypersensitivity and evidence of sinoatrial disease. There were no clinical signs or echocardiographic findings to suggest involvement of the aortic root or aortic valve. His arrhythmias were treated successfully with a physiological pacemaker. The combination of sinoatrial and atrioventricular node disease suggests that the inflammatory process in Reiter's syndrome can produce widespread involvement of the conducting system.

Adult↗
PubMed1988

Iodine in milk and the incidence of thyrotoxicosis in England.

Because iodine is added to cattle feed, milk and dairy products have become a major source of dietary iodine in Britain. The mean iodine concentrations of milk supplied to seven towns in England were measured each month throughout 1 year. Values were more than twice those recorded 20 years ago. There were large differences between the towns, with average annual concentrations ranging from 130 to 200 micrograms/l. Within the towns there were up to four-fold variations between the peak values in February/March and lowest values in June. The similarity between the monthly variations in milk iodine and seasonality in the onset of thyrotoxicosis suggests that iodine concentrations in milk and dairy products may now have reached harmful levels. Control of high winter levels in areas of Britain which were previously iodine deficient may now be necessary.

Animals↗
PubMed1988

Urinary iodine excretion correlates with milk iodine content in seven British towns.

In February and May 1986, weekly samples of whole pasteurised milk were collected from the 24 dairies supplying seven British towns. A random sample of 96 women aged 25-64 was drawn from general practitioners' lists in each town, and catch specimens of early morning urine were collected by post from 194 subjects in February and from 186 subjects in May. Median milk iodine concentration was significantly greater in February (235 micrograms/l) than in May (119 micrograms/l). The median urine iodine concentration (expressed per g of creatinine) was also greater in February (106 micrograms/g) than in May (78 micrograms/g). There was a strong and statistically significant correlation between milk and urine iodine concentrations in the seven towns in February (Spearman's r = 0.79, p = 0.04). Within the towns, the change in milk iodine levels between February and May was positively associated with the change in the iodine:creatinine ratio over the same period. There is concern that an excess of dietary iodine may be harmful to some individuals. Should it prove desirable to reduce iodine intakes at the community level, the present results suggest that this could be achieved by a reduction in milk iodine levels, which can be readily brought about by adjusting the levels of iodine in cattle feed.

Adult↗
PubMed1988

Efficacy of once daily nitrendipine in essential hypertension--a study using ambulatory blood pressure monitoring.

To determine if the calcium channel blocking agent, nitrendipine, is effective as monotherapy we have performed a double-blind placebo-controlled crossover trial using 20 mg once daily or twice daily in 19 mild to moderate hypertensive patients. Blood pressure was measured by a random zero (RZ) sphygmomanometer and at home using the Remler semiautomatic BP recorder. The BP (RZ) was significantly reduced by twice daily nitrendipine compared to placebo (from 163/99 +/- 20/6 mmHg to 140/90 +/- 15/9 mmHg). Once daily drug administration reduced systolic BP only (163 +/- 20 to 144 +/- 17 mmHg). Remler BP confirmed that the maximum systolic and diastolic BP lowering effect was in the twice daily group while once daily drug did produce a significant lowering of BP but less than the twice daily dosage. This study suggests that twice daily nitrendipine caused a greater decrease in BP and was more consistent than once a day. The emergence of a new generation of automatic BP recorders should improve the evaluation of once daily therapeutic agents.

Adult↗
PubMed1987

Measurement of antibodies to Candida albicans as a screening test for humoral immunodeficiency.

In screening for defects in humoral immunity, as well as measuring serum immunoglobulins it is advisable to have some measure of antibody production, e.g., immunising with a test antigen and measuring the antibody response some days later. However, this delay may be inconvenient and requires a second blood sample. An alternative is to test for antibody to a widespread commensal organism to which the patient must have been repeatedly exposed. The measurement of antibody to E. coli by haemagglutination has been previously used for this purpose. We report here that an equally good and simpler alternative is to measure antibodies to the commensal Candida albicans by immunofluorescence. Using a polyvalent conjugate, all 114 blood donors tested had antibody titres greater than 8 to C. albicans; similar responses were noted in 20 children (aged 6 months-16 years) without recurrent infections. In contrast, anti-candida responses were low or absent as expected in patients with hypogammaglobulinaemia but also in some patients with other immunodeficiency diseases. Overall candida immunofluorescence closely paralleled E. coli haemagglutination.

Antibodies, Fungal↗
PubMed1987

A geographical focus of duplex ureter.

Following the observation of an unusually high number of patients presenting with duplex ureter in Dorchester, a prospective study of 1930 autopsies was carried out in nine centres throughout the Wessex region. The prevalence of duplex ureter in Dorchester was 2.5% (5 of 200 autopsies) but did not exceed 0.6% elsewhere. The finding was confirmed by study of intravenous urograms in south-west Dorset carried out between 1982 and 1983, which showed a 6.0% prevalence of urinary tract duplication in radiographs from Dorchester.

Adult↗
PubMed1987

Clinical aspects of X-linked hypohidrotic ectodermal dysplasia.

Boys with X-linked hypohidrotic ectodermal dysplasia and their families were studied. Many suffered severe illness in early childhood and nearly 30% died; many had feeding problems, severe fever, atopic disease, and recurrent respiratory infections. Some infants failed to thrive. We found no consistent common endocrine or immunological abnormality, although, most had abnormal immunoglobulin production. This may be related to the abnormal mucosa of the gastrointestinal and respiratory tracts which exacerbates the chronic obstructive airways disease found later in life in those who smoke. Mental handicap was not a feature, although convulsions sometimes occurred during fever. Early diagnosis is important to avoid attacks of severe fever and so that rational management may be planned for other problems that arise. Dental advice should be sought before school age and genetic counselling may also be required. Many female carriers may be recognised at clinical examination: their affected sons can then be diagnosed more readily.

Adolescent↗
PubMed1987

Iodine intake and excretion in two British towns: aspects of questionnaire validation.

One hundred and eighty-nine women aged 25-64 years living in Preston and Southampton completed a postal questionnaire on their usual consumption of the major dietary sources of iodine. A subsample of 56 women collected 24-h urine specimens. Median iodine intakes based on the questionnaire responses and food consumption tables were 99 micrograms and 97 micrograms per day, respectively, but these figures rose to 105 micrograms and 118 micrograms when the women were given the opportunity to revise their original responses and analysed values for milk iodine were used. Median urinary iodine excretion (determined by the dry-ashing method) was 70 micrograms/day in Preston and 76 micrograms/day in Southampton. Although positive associations between intake and excretion were observed, the study lacked sufficient statistical power to validate the questionnaire as a measure of iodine intake. Some problems of questionnaire validation are discussed.

Adult↗
PubMed1985

The geographical distribution of thyrotoxicosis in England according to the presence or absence of TSH-receptor antibodies.

In a prospective study of the incidence of thyrotoxicosis sera from 216 thyrotoxic patients in seven English towns were assayed for TSH-receptor antibodies. The incidence of antibody negative thyrotoxicosis correlated closely with the previous prevalence of endemic goitre in the towns (r = 0.9) indicating a high current incidence of toxic nodular goitre in previously goitrous towns. Antibody positive thyrotoxicosis, an indicator of Graves' disease, showed no correlation with goitre although there was statistically significant geographical variation in incidence. The percentage of all thyrotoxic patients who were antibody positive varied between towns, from 35% to 92%.

Adolescent↗
PubMed1985

Seasonality of thyrotoxicosis.

Study of a large and representative series of thyrotoxic patients showed a higher frequency of diagnosis in the spring and summer. The median interval between onset and diagnosis was 12 weeks, indicating a peak in onset of the disease from January to June. The seasonality of thyrotoxicosis may be related to seasonal variations in iodine intake.

Adolescent↗
PubMed1985

Seasonal variations in dietary iodine intake and thyrotoxicosis.

Food composition tables were used to estimate the iodine intake of 105 men and 112 women living in Cambridge who completed 7-day semi-weighed records of food consumption. Intakes in men ranged from 195 micrograms per day in summer to 306 micrograms in winter, and in women from 126 micrograms to 236 micrograms. Seasonal variations in intake were mainly due to seasonal differences in the iodine content of milk which varies directly in relation to farming practices. The authors speculate that a spring-summer peak in thyrotoxicosis incidence in Britain may be causally related to the high milk iodine levels in winter.

Adolescent↗
PubMed1984

Current incidence of thyrotoxicosis and past prevalence of goitre in 12 British towns.

The incidence of thyrotoxicosis was determined in a collaborative study in 12 towns in England and Wales. Cases were ascertained prospectively through biochemistry laboratories carrying out routine thyroid function tests. The annual incidence varied from 9.7 to 49.2 per 100 000. Reassay of sera at a reference laboratory showed that this variation did not result from inter-laboratory differences in the techniques for measuring thyroid function. The incidence of thyrotoxicosis was strongly correlated with the previous prevalence of endemic goitre in the towns. Current high dietary intakes of iodine--largely the result of milk contamination--may cause toxic nodular goitre in people made susceptible by a lack of iodine early in life. They may also contribute to the occurrence of Graves' disease.

Adolescent↗
PubMed1983

Mortality from thyrotoxicosis in England and Wales and its association with the previous prevalence of endemic goitre.

The distribution of mortality from thyrotoxicosis among women in England and Wales during 1968-78 correlates with the previous prevalence of endemic goitre. Mortality from the disease rose to a peak in the decade 1931-40 and then declined. This peak affected all age groups and can be attributed to the high fatality from surgery before the introduction of preoperative iodine to prevent thyroid crisis. An apparent cohort effect, whereby cohorts born from 1871 to 1886 experienced the highest mortality, may be explained by generations with a high prevalence of endemic goitre becoming exposed to increasing dietary iodine intake in later life.

Adult↗