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Biomedical subjects

D M Phillips

Publications and source records attributed to D M Phillips.

206 records · Page 12Linked to original sources
PubMedDate not supplied

Insect cell cultures in the study of attachment and pathogenicity of spiroplasmas and mycoplasmas.

The insect cell lines Dm-1 (Drosophila melanogaster), AS-2 (Aceratagallia sanguinolenta) and AC-20 (Agallia constricta) were infected with spiroplasmas, mycoplasmas and Acholeplasma laidlawii. In Dm-1 cultures maintained at 25 degrees C in M1A medium, all strains multiplied except M. hyorhinis and the uncultivable sex-ratio organism. Spiroplasma citri R8A2, S. floricola BNR-1 and OBMG, S. apis PPS-1 and the strains BC-3, corn stunt spiroplasma (CSS) and 277F produced cytopathogenic effects (CPE), whereas S. mirum SMCA, M. orale, M. arginini and A. laidlawii did not. Cytadsorption was found with the cultivable spiroplasmas and A. laidlawii. At 30 degrees C SMCA, M. orale, M. arginini and A. laidlawii killed the Dm-1 cultures. M. hyorhinis grew without any CPE. In AS-2 and AC-20 cultures grown at 28 degrees C in LB medium, R8A2, B88, 277F, BNR-1 and PPS-1 multiplied and reached titres of 2 X 10(8) to 4 X 10(9) CFU/ml. They produced CPE leading to culture death. CSS did not grow. R8A2 reached higher titres in AS-2 cultures than in fresh LB medium. This stimulating factor was studied by means of conditioned medium. All 6 spiroplasmas cytadsorbed to AS-2 and AC-20 cells. B88 and 277F adsorbed heavily, while the other 4 strains adsorbed only slightly. Fluorescent DNA staining with "Hoechst 33258" revealed the presence of non-helical forms inside the cells.

Acholeplasma↗
PubMedDate not supplied

Health status, staffing, and medicaid reimbursement in nursing homes: 1985 to 1995.

CONTEXT: Policy changes implemented by Medicaid and Medicare in the early 1980s resulted in a functionally more dependent nursing home population. OBJECTIVES: This paper contends that (1) staffing in nursing homes has become more efficient; (2) nursing home residents are functionally more dependent;(3) Medicaid per diem reimbursement is inadequate. DATA SOURCES: Staffing data came from the National Nursing Home Facility Survey conducted by the National Center for Health Statistics (NCHS) in 1985 and 1995. Functional dependency data, defined as assistance with any of six Activities of Daily Living (ADLs), came from the NCHS National Nursing Home Current Resident Surveys in 1985 and 1995. Reimbursement rates came from the State Medicaid Reimbursement Surveys conducted by the University of California at San Francisco to which the Consumer Price Index, Hospital and Related Services Item was applied. DATA SYNTHESIS: Administration decreased by 4.4 full-time equivalents (FTEs) (80.0%) per 100 beds, whereas patient care increased by 8.2 FTEs (18.9%). Residents requiring assistance with four or more ADLs increased by 9.9%, and the mean number of ADLs per patient increased from 3.9 to 4.3. Applying the Consumer Price Index to the 1984 reimbursement rate indicated an annual deficit of 5526.00 dollars for each Medicaid patient by 1995. CONCLUSIONS: This research strongly supports its contentions but fails to demonstrate them conclusively. The data indicate that long-term care facilities have reallocated staffing to accommodate the requirements of more functionally dependent residents and that Medicaid reimbursement has failed to maintain its initial purchasing power.

Journal Article↗
PubMedDate not supplied

A comparison of the attitudes of obstetricians and family physicians toward obstetric practice, training, and hospital privileges of family physicians.

Responses of national samples of 329 residency-trained family physicians and 237 obstetricians were studied to determine the attitudes of family physicians and obstetricians toward the practice of obstetrics by family physicians. The attitudes of obstetricians and family physicians varied greatly, and the attitudes of obstetricians toward obstetric care provided by family physicians tended to become less supportive following the time of the obstetricians' training. In particular, obstetricians felt strongly that family physicians were inadequately trained to provide uncomplicated obstetric care. These negative attitudes were reflected in obstetricians' opinions regarding hospital obstetric privileges for family physicians. From a list of 11 obstetric privileges, obstetricians indicated that residency-trained family physicians should be granted a mean of 2.2 privileges, while family physicians who currently practice obstetrics indicated a mean of 6.6 (P less than .001). Family physicians who felt well supported by obstetricians during their obstetric training were more likely to develop positive attitudes toward obstetric practice than those who were not well supported. Both obstetricians and family physicians indicated that the adequacy of maternity care in rural areas would decline if family physicians withdrew from maternity care. There was strong agreement that rising malpractice premiums may soon force family physicians to stop delivering babies. This study concludes that there are vast differences among obstetricians and family physicians in perceptions regarding obstetric practice by family physicians which may adversely affect such practice.

Adult↗
PubMedDate not supplied

Gas exchange and haemodynamics during high frequency body surface oscillation in rabbits.

To establish the clinical feasibility of high frequency body surface oscillation (HFBSO) as a mode of controlled ventilation for infants and to examine its effects on basic haemodynamic parameters, we studied twelve intact rabbits in two groups. The animals were placed in a body chamber with their heads remaining outside through a neck-hole. The mean chamber pressure was maintained at -3 to -4 cmH2O and a piston pump, operating at 3, 6, 9, 12 and 15 Hz, created pressure swings in the chamber, thus generating oscillatory tidal volumes. A fresh-airflow of 2 1.min-1 was used over the mouth. In the first group of six rabbits, we obtained the relationship between tidal volume (VT) and frequency (f) which maintained a normocapnic state (PaCO2 = 40 +/- 2 mmHg) when the animals were paralysed. The average tidal volumes required were between 1.36 and 1.78 ml.kg-1 for the 3-15 Hz frequency range, or about 1/4 of the spontaneous tidal volume. The corresponding mean PaO2 was 66.7 mmHg at 3 Hz and 73.4 mmHg at 9 Hz. These results indicate that adequate ventilation and acceptable gas exchange took place in these experimental animals during HFBSO. In the second group, six rabbits were catheterized with catheter-tip pressure transducers in order to obtain the aortic (ABP), central venous (CVP) and intrathoracic pressures. The arterial pressure profile was severely deranged by HFBSO, but, electronic subtraction of the intrathoracic pressure swings from the ABP signal resulted in the return of the normal pressure profile.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

The immunohistochemical localization of alpha 2-macroglobulin in rat testes is consistent with its role in germ cell movement and spermiation.

alpha 2-Macroglobulin (alpha 2-MG) is a nonspecific protease inhibitor and binding protein for peptide hormones that was recently isolated from Sertoli cell-enriched culture medium and shown to be the same protein as alpha 2-MG in serum. The present study was conducted to determine the localization of alpha 2-MG in the seminiferous epithelium in order to gain insight into its possible site(s) of action. Immunostainable alpha 2-MG was present in the lumen of the tubules consistent with its proposed role as a protease inhibitor needed to inactivate the protease released from defective spermatozoa in the male reproductive tract. Immunoreactive alpha 2-MG was also localized adjacent to the heads of elongated spermatids, the most mobile cells in the seminiferous epithelium; immunostainable alpha 2-MG was not observed adjacent to round spermatids and spermatocytes, which are relatively less mobile. The intensity of the staining around the elongated spermatids was dependent on the stage of the spermatogenic cycle. Stainable alpha 2-MG was present adjacent to the spermatids in stage XI soon after the elongation process began. Immunoreactive product was in stages XI-XIV but only faintly visible. The most intense staining reaction for alpha 2-MG was in stages I-VI; it was reduced in stage VII; and virtually no alpha 2-MG was detectable in stages VIII-X at and just after spermiation. The postnatal changes of alpha 2-MG in the testis was also examined. During the first 2 weeks after birth, alpha 2-MG was not detected in the seminiferous epithelium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Testis factors that may regulate gene expression: evidence from a patient with Kartagener's syndrome.

Patients with Kartagener's syndrome characteristically have immotile cilia and flagella. Ultrastructural analysis of the efferent ducts of the patient described in this report revealed that the cilia totally lacked dynein arms. Based on clinical findings his respiratory cilia also were not functional. In contrast, this patient's spermatozoa were motile and displayed normal ultrastructure, including dynein arms. This suggests that two genes exist that code for slightly different proteins with analogous functions; one of these genes functions in somatic tissue and the other in the male germ tissue. Differential gene expression in somatic and male germ tissue may be related to the syncytial nature of male germ cells, low scrotal temperature, or haploid gene expression.

Adult↗
PubMedDate not supplied

Overtime reduction with the press of a button. An unexpected outcome of computerized documentation.

Overtime takes its toll on the staff and creates an opportunity to control cost. The purpose of this research was to investigate actual and perceived overtime amounts of nursing staff members before and after the implementation of a handheld computerized patient documentation system. Overtime amounts have decreased 29% since implementation of the system. Advantages and disadvantages of the system are also discussed.

Cost Control↗