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Biomedical subjects

D Phillips

Publications and source records attributed to D Phillips.

At least 37 records · Page 2Linked to original sources
PubMed2001

Treatment of acute low back pain in Wisconsin: results of the State Medical Society's Medical Outcomes Research Project.

BACKGROUND: Acute low back pain is the fifth most common reason for physician visits. Multiple treatment options are available, but not all physicians and patients are satisfied with the results. This study evaluated treatment outcomes from patients' perspectives using standardized measures. METHODS: 368 patients with acute low back pain were enrolled in the study. Only 128 participants (35%) completed all 4 health outcome questionnaires (administered at baseline, 6 weeks, 3 months, and 1 year). RESULTS: Most participants reported improved health at 1-year follow-up,, with the most significant gains achieved by 3 months. However, 40% were not satisfied with their outcome. Patients with radicular low back pain scored lower on health outcome measures than patients without radicular symptoms. CONCLUSION: A sizeable percentage of patients with acute low back pain progress to chronic pain despite therapeutic intervention. Patients with radiculopathy may require nonstandard treatment to avoid unfavorable outcomes.

Acute Disease↗
PubMed2000

Analysis of the HIV-1 LTR NF-kappaB-proximal Sp site III: evidence for cell type-specific gene regulation and viral replication.

It has been widely demonstrated that the human immunodeficiency virus type 1 (HIV-1) envelope, specifically the V3 loop of the gp120 spike, evolves to facilitate adaptation to different cellular populations within an infected host. Less energy has been directed at determining whether the viral promoter, designated the long terminal repeat (LTR), also exhibits this adaptive quality. Because of the unique nature of the cell populations infected during the course of HIV-1 infection, one might expect the opportunity for such adaptation to exist. This would permit select viral species to take advantage of the different array of conditions and factors influencing transcription within a given cell type. To investigate this hypothesis, the function of natural variants of the NF-kappaB-proximal Sp element (Sp site III) was examined in human cell line models of the two major cell types infected during the natural course of HIV-1 infection, T cells and monocytes. Utilizing the HIV-1 LAI molecular clone, which naturally contains a high-affinity Sp site III, substitution of low-affinity Sp sites in place of the natural site III element markedly decreased viral replication in Jurkat T cells. However, these substitutions had relatively small effects on viral replication in U-937 monocytic cells. Transient transfections of HIV-1 LAI-based LTR-luciferase constructs into these cell lines suggest that the large reduction in viral replication in Jurkat T cells, caused by low-affinity Sp site III variants, may result from reduced basal as well as Vpr- and Tat-activated LTR activities in Jurkat T cells compared to those in U-937 monocytic cells. When the function of Sp site III was examined in the context of HIV-1 YU-2-based LTR-luciferase constructs, substitution of a high-affinity element in place of the natural low-affinity element resulted in increased basal YU-2 LTR activity in Jurkat T cells and reduced activity in U-937 monocytic cells. These observations suggest that recruitment of Sp family members to Sp site III is of greater importance to the function of the viral promoter in the Jurkat T cell line as compared to the U-937 monocytic cell line. These observations also suggest that other regions of the LTR may compensate for Sp recruitment defects in specific cell populations.

Base Sequence↗
PubMed2000

Comparative genomic hybridization in combination with flow cytometry improves results of cytogenetic analysis of spontaneous abortions.

More than 50% of spontaneous abortions (SAs) have abnormal chromosomes; the most common abnormalities are trisomy, sex chromosome monosomy, and polyploidy. Conventional cytogenetic analysis of SAs depends on tissue culturing and is associated with a significant tissue culture failure rate and contamination by maternally derived cells. Comparative genomic hybridization (CGH), in combination with flow cytometry (FCM), can detect numerical and unbalanced structural chromosomal abnormalities associated with SAs while avoiding the technical problems associated with tissue culture. Routine cytogenetic and CGH analysis was performed independently on tissue from 301 SAs. Samples shown to be chromosomally balanced by CGH were analyzed by FCM to determine ploidy. Of 253 samples successfully analyzed by both approaches, there was an absolute correlation of results in 235 (92.8%). Of the 18 cases with discrepancies between cytogenetic and CGH/FCM results, an explanation could be found in 17. Twelve samples produced a 46,XX karyotype by cytogenetics, whereas CGH/FCM demonstrated aneuploidy/polyploidy or a male genome, indicating maternal contamination of the tissue cultures. In two cases, where tetraploidy was demonstrated by cytogenetics and diploidy by FCM, tissue culture artifact is implied. In three cases, CGH demonstrated an aneuploidy, and cytogenetics demonstrated hypertriploidy. In one unexplainable case, aneuploidy demonstrated by CGH could not be detected by repeat CGH analysis, conventional cytogenetic, or FISH analysis. These results demonstrate that CGH supplemented with FCM can readily identify chromosomal abnormalities associated with SAs and, by avoiding maternal contamination and tissue culture artifacts, can do so with a lower failure rate and more accuracy than conventional cytogenetic analysis.

Abortion, Spontaneous↗
PubMed2000

Use of the stable isotope (106)Cd for studying dietary cadmium absorption in humans.

Hydroponically grown wheat was intrinsically labelled with the stable isotope 106cadmium (106Cd) and the flour made into a porridge. The abundance of the isotope in the porridge was approximately 30 times the natural abundance, but the total level of Cd in the porridge was 0.03 mg/kg fresh weight, which was the same as expected in a normal diet. Cadmium measurements were made using inductively coupled plasma-mass spectrometry (ICP-MS). The porridge was eaten at breakfast by adult and infant volunteers. Bulked faecal collections were analysed for unabsorbed Cd. Initial results suggest that the apparent absorption of Cd may be higher than 5% as commonly quoted, but longer faecal collection times may be necessary to confirm this.

Adult↗
PubMed2000

Triplet-state photophysics of aluminium phthalocyanine sensitizer in murine cancer cells.

Diffuse-reflectance laser flash photolysis has been used to record transient spectra and decay kinetics of the photodynamic therapy sensitizer disulfonated aluminium phthalocyanine in two murine cancer cell lines, P815 derived from white mouse mast cells, and EL4, a lymphoblast derived from black mouse lymphocytes. In contrast to results with bacterial cells and yeasts, no transient other than the triplet state of the sensitizer was detected, suggesting that unlike the case in microbes, Type I electron-transfer processes play no role in the photodestruction of the murine cells studied.

Aluminum↗
PubMed2000

Norm values for the Generic Children's Quality of Life Measure (GCQ) from a large school-based sample.

This study aimed to assess the quality of life of a population sample of schoolchildren. The Generic Children's Quality of Life Measure (GCQ) has been developed to allow comparison between chronically ill children and the general child population. The measure assesses how the child views his or her life and also how they would like it to be. Quality of life is measured as the discrepancy between the two viewpoints. This large community-based survey aimed to establish GCQ norm values for children aged 6-14 years. The children were from a sample of schools stratified by geographical location and social need: rural affluent, rural low affluence, urban affluent and urban low affluence. 720 completed questionnaires were analysed. The scores were normally distributed with a wide range. The GCQ showed an acceptable reliability with a Cronbach's alpha of 0.75. The quality of life score was not correlated with age (r = -0.02, p = 0.64) nor with the deprivation score of the area in which the children lived (r = -0.026, p = 0.49). There were no significant differences between the scores by gender (p = 0.22) nor by rural/urban location (p = 0.60). Normative values were established. The GCQ is suitable for using with children over a large age range (6-14 years) without the scores being confounded by the age, gender, affluence or geographical location.

Adolescent↗
PubMed2000

Investigation of the effect of marathon running on leucocyte counts of subjects of different ethnic origins: relevance to the aetiology of ethnic neutropenia.

Healthy subjects of African ancestry, including Afro-Caribbeans, have been observed to have lower total white cell counts and neutrophil counts than healthy Caucasian subjects. The cause of this ethnic neutropenia is unclear. We have previously found no evidence that increased margination of neutrophils is responsible. In this study, we have investigated mobilization of neutrophils from the bone marrow granulocyte reserve by endurance exercise. We investigated subjects of different ethnic origins before and after they had competed in a marathon race. Before the race, the neutrophil counts of Africans/Afro-Caribbeans were significantly lower than those of Caucasians (means 2.49 and 3.21 x 109/l respectively; P = 0.043). After the race, the difference was greater, as was the degree of significance (means 10.21 and 12.33 respectively; P = 0.017). The percentage increment was almost identical whereas the absolute increment was considerably less, although of marginal statistical significance (increment 7.72 and 9. 12 x 109/l respectively; P = 0.10). Similar changes were observed in the monocyte count. Before the race, the difference in the means was of marginal statistical significance (0.35 and 0.41 x 109/l respectively; P = 0.105), whereas after the race the difference was greater and was highly significant (means 0.75 and 1.05 x 109/l respectively; P = 0.001). These observations support the results of our earlier study, both of which suggested that ethnic neutropenia is likely to result from a diminished bone marrow reserve rather than being consequent on altered distribution of neutrophils within the blood stream.

Adult↗
PubMed2000

Prospective 5-year audit for day-case laparoscopic cholecystectomy

AIMS: Laparoscopic cholecystectomy can be performed as a day-case procedure but success depends on adequate recovery time, patient motivation and physical condition. To determine the proportion of patients suitable for a day-case procedure, 23-h stay and inpatient treatment, a prospective audit was introduced in 1994. METHODS: A 5-year (1994-1999) prospective annual audit was performed for all patients undergoing laparoscopic cholecystectomy (537 patients). In the first 3 years patients were either classified as day-case or inpatient stay; the establishment of a 23-h stay ward allowed a third option for these patients. RESULTS: Day-case laparoscopic cholecystectomy, including 23-h stay in the final 2 years of the audit, increased in each of the 5 years from 16 to 80 per cent. The audit loop was closed when the successful allocation rate for day-case patients was reaudited; this increased from 56 per cent in the first year to 88 per cent in the final year. CONCLUSIONS: This audit has identified the need for extended recovery for patients undergoing more major procedures on an ambulatory basis such as laparoscopic cholecystectomy. Further refinements in selection criteria and improved analgesia control are needed to reduce the unexpected extended stay for day-case and ambulatory patients.

Journal Article↗
PubMed2000

Exercise induced mobilisation of the marginated granulocyte pool in the investigation of ethnic neutropenia.

This study was designed to determine whether ethnic neutropenia is caused by an increased proportion of neutrophils being present in the marginated granulocyte pool. Thirty two healthy volunteers, half of whom were African or Afro-Caribbean and half of whom were white, exercised vigorously for 10 minutes on a step machine to mobilise granulocytes from the marginated granulocyte pool into the circulating granulocyte pool. The amount of work performed and the pulse rate response of the two ethnic groups were compared to determine whether the exercise carried out was comparable. A full blood count and an automated differential count were performed before and after the exercise. The haemoglobin concentration, platelet count, and absolute counts of total leucocytes and leucocyte subsets before and after exercise were compared in each individual and the values in the two ethnic groups both before and after exercise were compared. The absolute increase in neutrophils in the two ethnic groups was compared. The African/Afro-Caribbean group was found to have a reduced rather than enhanced ability to mobilise neutrophils from the marginated granulocyte pool. Therefore, increased margination of neutrophils is unlikely to be the cause of ethnic neutropenia.

Adolescent↗
PubMed2000

The effect of pH on the photophysics and photochemistry of disulphonated aluminum phthalocyanine

The results of a study of the effect of pH on the photophysics and photochemistry of di-sulphonated aluminum phthalocyanine (AlPcS2) in aqueous solution are presented. The pH dependence of the triplet quantum yield, fluorescence quantum yield, singlet-oxygen quantum yield, triplet lifetime, fluorescence lifetime and apparent dimerization constants is investigated and the results interpreted in terms of the pH dependence of the nature of the axial ligands. Evidence that the aluminum-axial ligand bond strength, rather than dimer binding energy that determines the extent of dimerization is provided by semi-empirical and ab initio calculations. Possible dimer structures obtained using ab initio calculations are discussed.

Journal Article↗
PubMed2000

Mosquito isolates of Ross River virus from Cairns, Queensland, Australia.

During 1996-1998 60,619 mosquitoes were collected around Cairns, Australia and processed for Alphavirus isolation. Thirty-three isolates of Ross River (RR) virus were made from 9 species, Aedes imprimens, Aedes kochi, Aedes notoscriptus, Aedes vigilax, Culex annulirostris, Culex gelidus, Mansonia septempunctata, Verrallina (formerly Aedes) carmenti, and Verrallina lineatus. Attempts to isolate RR virus from 121 Aedes aegypti were unsuccessful. Twenty-six (79%) of the isolates came from within 1 km of a colony of spectacled flying-foxes, Pteropus conspicillatus. The minimum infection rate for these mosquitoes was 1.0 compared with 0.2 per 1,000 for mosquitoes trapped at all other sites. Ross River virus has not previously been isolated from Ae. imprimens, Cx. gelidus, Ma. septempunctata, Ve. carmenti, or Ve. lineatus. This is also the first isolation of an arbovirus from Cx. gelidus in Australia. In conclusion, the vector status of Ve. carmenti, Ae. aegypti and Ma. septempunctata warrants further study. This study also provides evidence that P. conspicillatus may be a reservoir host.

Animals↗
PubMed2000

Protecting human health in a changing world: the role of social and economic development.

The biological and physical environment of the planet is changing at an unprecedented rate as a result of human activity, and these changes may have an enormous impact on human health. One of the goals of human development is to protect health in the face of rapid environmental change, but we often fail to do this. The aim in this paper is to distinguish between socioeconomic aspects of development that are likely to be protective and those that are likely to increase vulnerability (the capacity for loss resulting from environmental change). Examples include climate change in the Pacific. We conclude that protecting human health in a changing world requires us to take steps to minimize harmful change wherever possible, and at the same time to be prepared for surprises. The goals of mitigation (reducing or preventing change) and adaptation (response to change) are not mutually exclusive. In fact, steps to make populations more resilient in the face of change are often similar to those that are needed to lighten the load on the environment. We need social policies that convert economic growth into human development. Wider application of sustainable development concepts is part of the solution. In particular, there is a need to promote health as an essential asset of poor and vulnerable populations. It is their key to productivity and to surviving shocks; it is also the key to achieving broader development goals such as universal education. For these reasons it is in the interests of all sectors--economic, social and environmental--to play their particular roles in protecting and improving health.

Adult↗
PubMed1999

Kinetic and equilibrium studies of incorporation of di-sulfonated aluminum phthalocyanine into unilamellar vesicles.

The interactions of cis-di-sulfonated aluminum phthalocyanine (PcS(2)Al) with dimyristoylphosphatidylcholine (DMPC) unilamellar vesicles have been investigated by fluorescence spectroscopy. At pH 7.0, PcS(2)Al incorporates into the vesicles with a high affinity constant (2.7x10(6) M(-1), in terms of phospholipid concentration). The fluorescence changes following rapid mixing of PcS(2)Al with vesicles are biphasic. The first phase is attributed to the entry of PcS(2)Al into the vesicles, as deduced from the linear dependence of the rate upon lipid concentration. More surprisingly, this rate is strongly pH dependent with a marked maximum around pH 7.3, a result interpreted in terms of the coordination state of the aluminum ion in aqueous solutions. At this pH, a hydroxide ion neutralizes the residual positive charge of the metal ion that remains unbalanced after coordination by the phthalocyanine cycle. A water molecule is likely to complete the metal coordination sphere. Only this form, PcAl(+)(OH(-))(OH(2)), with an uncharged core is quickly incorporated into the vesicles. The protonation of OH(-) or the deprotonation of the coordinated H(2)O leading to a positively or negatively charged core, respectively, account for the observed pH effect. Studies on the effect of cholesterol addition and exchange of PcS(2)Al between vesicles and albumin all indicate the absence of transfer of the phthalocyanine between the vesicle hemileaflets, a result expected from the presence of the two negatively charged sulfonated groups at the ring periphery. Instead, the slower kinetic phase is likely due to the movement of the phthalocyanine becoming more buried within the outer leaflet upon the loss of the water molecule coordinated to the aluminum ion.

Biological Transport, Active↗
PubMed1999

Low-risk endometrial carcinoma: assessment of a treatment policy based on tumor ploidy and identification of additional prognostic indicators.

OBJECTIVES: The aims of this study were (1) to assess a treatment policy for patients with low-risk endometrioid endometrial carcinoma where adjuvant treatment decisions have been based on ploidy status of the tumor, and (2) to screen diploid, low-risk tumors for additional features of prognostic significance. METHODS: Between 01/1992 and 08/1996, 406 patients were referred to the B.C. Cancer Agency-Vancouver Clinic with typical endometrial adenocarcinomas limited to <50% myometrial invasion and no vascular space invasion or grade 3 disease on pathology review ("low-risk stage I endometrial carcinoma"). Patients were prospectively assigned to treatment groups based on tumor ploidy. Those patients with aneuploid tumors (n = 91) were treated with adjuvant vaginal vault radiotherapy while those with diploid tumors (n = 315) were followed and treated only at relapse. The hysterectomy specimens from all 14 patients in the untreated, diploid group who relapsed, as well as 28 stage- and grade-matched diploid controls who did not fail, were analyzed by immunohistochemical staining for estrogen receptor (ER), Bcl-2, and p53 proteins. RESULTS: There were no significant differences in the stage (Ia vs Ib) and grade (G1 vs G2) distribution for the diploid and aneuploid groups. Overall median age was 64 years (range 27-90 years) and was also not significantly different for the two groups. The median follow-up for the entire cohort is 45 months (range 1-76 months). There have been 14 failures in the diploid group and 4 failures in the aneuploid group with actuarial 5-year disease-free survival rates of 95.0 and 95.2%, respectively (P = NS). Eight of the failures in the diploid group occurred at the vaginal vault and were all subsequently salvaged with radiotherapy. All but 1 of the failures in the aneuploid group were considered incurable. Of the 14 diploid tumors from patients who failed, 7 stained positively for p53, compared to 4 of 28 diploid controls (P = 0.02). No significant differences were seen in the diploid tumors that recurred, compared to controls, with respect to Bcl-2 or ER expression. CONCLUSIONS: Patients with diploid, low-risk stage I endometrial cancers have excellent prospects for relapse-free and overall survival. Patients with aneuploid tumors treated with adjuvant radiotherapy have the same risk of relapse as untreated patients with diploid tumors; however, their ultimate survival may be lower as a smaller proportion of aneuploid failures are salvageable. While p53 expression in diploid tumors is associated with increased risk of relapse, Bcl-2 and ER are not useful prognostic indicators in this setting.

Adult↗
PubMed1999

Late stages of epidemiological transition: health status in the developed world.

Drawing on the example of twentieth century Europe, this paper examines themes in the spatial development of the late stages of epidemiological transition in developed countries. A preliminary analysis of mortality trends for sample countries in four European regions (north, Scandinavia, south and east) suggests that, as the epidemiological transition progressed to its later stages during the period 1901-1975, spatial variability in the importance of classical infectious diseases increased. This trend was countered by a spatial convergence in the importance of disease groupings that typify late transition. An apparently new epidemiological phase in late transition, linked to the emergence and re-emergence of infectious and parasitic diseases, is illustrated with reference to tuberculosis and the acquired immunodeficiency syndrome (AIDS).

Communicable Diseases↗
PubMed1999

"Patient was hit in the face by a fist..." a discourse analysis of male violence against women.

A discourse analysis of professional and popular literature describing male violence against women surveyed 165 abstracts and 11 full-length articles. The phrase "male violence" was used only eight times in these writings; male gender was infrequently mentioned, whereas female gender was often present in the identification of victims of male violence. Consequences of the absence of men as perpetrators and visibility of women in the literature on male violence against women are discussed, and change in these discursive practices is called for.

Cultural Characteristics↗