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Biomedical subjects

P J Phillips

Publications and source records attributed to P J Phillips.

At least 37 records · Page 2Linked to original sources

Asthma and chronic obstructive airway diseases are associated with osteoporosis and fractures: a literature review.

The objective was to assess the association between asthma and/or chronic obstructive airway diseases (COAD), and osteoporosis, and appraise treatments of osteoporosis in these patients. MEDLINE and Excerpta Medica were searched for original research with control groups which tested the above association. One cohort and nine cross-section studies of bone density in patients with asthma and/or COAD were retrieved. These demonstrated clinically important bone density reductions of up to 29% in subjects, dependent upon daily oral corticosteroids, by a variety of measurement techniques, at various bone sites. Bone density reduction has also been less consistently reported in the absence of oral corticosteroids, suggesting that other factors including high-dose inhaled corticosteroids may have a role. Fracture studies. Three studies in oral corticosteroid-dependent asthmatics demonstrated a vertebral fracture prevalence up to 56%, and annual vertebral fracture incidence of up to 42%. The strength of the available evidence is limited, but suggests that patients with asthma and/or COAD are at increased risk of osteoporosis. The evidence of the association between osteoporosis and inhaled corticosteroids is much more limited than for oral corticosteroids. Bisphosphonates are promising agents to maintain and/or promote bone mass in this patient group.

Administration, Inhalation↗

Barriers to minority participation in the orthopaedic profession. Personal perspectives.

A brief summary of one individual's pathway and the challenges encountered along the road to becoming an orthopaedic surgeon are outlined. Beginning with the decision to pursue a career in medicine, and chronicling the subsequent decisions made along the way, key elements that facilitated this individual's success are reviewed. Some of the difficulties encountered from the perspective of a minority candidate also are discussed and what perhaps may be deemed an indirect pathway to an orthopaedic career. The importance of institutional support, mentorship, and recruitment are essential to facilitate and secure the success of minority candidates.

Career Choice↗

Public perceptions and self-reported prevalence of osteoporosis in South Australia.

The self-reported prevalence of, and attitudes to and perceptions of, osteoporosis in the South Australian community were assessed using data collected as part of the 1995 South Australian Health Omnibus Survey (household interviews)--a clustered, self-weighting, multistage sample of households in metropolitan and country centers. The self-reported prevalence was 4.8 (95% CI: 3.7-5.8) and 1.4% (95% CI: 0.8-2.0) for women (n = 1531) and men (n = 1485) respectively. For individuals with osteoporosis, calcium was the favored treatment (52%), while 33% of women were on hormone replacement therapy. An appropriate definition of osteoporosis was given by 62% of women and 37% of men. The main risk factors were reported as lack of calcium and age. There was a significant association between knowledge of the definition of osteoporosis and identification of correct risk factors. A high perceived risk of osteoporosis was reported in 23% of women and 7% of men. Osteoporosis risk was assessed as higher in those who did not adopt recognized prevention measures. Perception of risk was not related to the individual's own risk factors. Self-reported prevalence of osteoporosis significantly underestimates the likely true prevalence and general awareness and knowledge is much lower for men than women. The importance of individual risk factors for osteoporosis are not understood by the general community.

Adolescent↗

Adaptation in patterns of c-fos expression in the brain associated with exposure to either single or repeated social stress in male rats.

Intraspecific confrontation between male rats represents a biologically relevant form of social stress. C-fos expression has been used to map the pattern of neural activation following either a single (acute) or repeated (10 times) exposure of an intruder male to a larger male in the latter's home cage. These conditions induce high levels of aggressive interaction. Sixty minutes after a single defeat, there was intense c-fos expression (quantified using image analysis) in restricted areas of the basal forebrain (including lateral septum, bed nucleus of stria terminalis, lateral preoptic area, lateral hypothalamic area, paraventricular nucleus, and medial and central amygdala) as well as in the autonomic and monoaminergic nuclei of the brainstem (central grey, dorsal and median raphe, locus coeruleus and nucleus of the solitary tract). After the tenth defeat, this pattern was modified despite persistently high levels of aggression. Some areas in the forebrain (bed nucleus of stria terminalis, paraventricular nucleus and medial amygdala) continued to express increased c-fos; others (the septum, lateral hypothalamic area, lateral preoptic area and central amygdala) no longer expressed c-fos. The brainstem response was equally varied: the central grey and the raphe nuclei continued to respond after repeated defeat, whereas the solitary nucleus and locus coeruleus did not. On the other hand, there was no change in the behaviour of intruder rats after repeated defeat. This study shows the pattern of adaptation at a cellular level in the basal forebrain and brainstem to repeated defeat. As in our previous studies of repeated restraint, modulation in the expression of c-fos following repeated stress is highly regionally specific, suggesting that differential neural processing is involved in adaptation to social stress.

Adaptation, Psychological↗

The design of matching pursuit filters.

This paper presents a new technique for creating efficient and compact models from data, called matching pursuit filters. The design of a matching pursuit filter is based on an adapted wavelet expansion, where the expansion is adapted to both the data and the pattern recognition problem being addressed. This contrasts with most adaptation schemes, where the representation is a function of the data, but not of the problem to be solved. This approach does not decompose the images in the training set individually, but rather determines the expansion by simultaneously decomposing all the images. Because it uses two-dimensional wavelets as the building blocks for the decomposition, the representation is explicitly two-dimensional and is composed of local information. Matching pursuit filters can be trained to detect, recognize, or identify objects and have been applied to recognizing faces and detecting objects in infrared imagery.

Algorithms↗

Sustained activation of extracellular-signal-regulated kinase 1 (ERK1) is required for the continued expression of cyclin D1 in G1 phase.

In Chinese hamster embryo fibroblasts (IIC9 cells), platelet-derived growth factor (PDGF) stimulated mitogen-activated protein kinase/extracellular-signal-regulated kinase (MAP kinase/ERK) activity, but not that of c-jun N-terminal kinase (JNK), and induced G1 phase progression. ERK1 activation was biphasic and was sustained throughout the G1 phase of the cell cycle. PDGF induced cyclin D1 protein and mRNA levels in a time-dependent manner. Inhibition of PDGF-induced ERK1 activity by the addition of a selective inhibitor of MEK1 (MAP kinase kinase/ERK kinase 1) activation, PD98059, or transfection with a dominant-negative ERK1 (dnERK-) was correlated with growth arrest. In contrast, growth was unaffected by expression of dominant-negative JNK (dnJNK-). Interestingly, addition of PD98059 or dnERK-, but not dnJNK-, resulted in a dramatic decrease in cyclin D1 protein and mRNA levels, concomitant with a decrease in cyclin D1-cyclin-dependent kinase activity. To investigate the importance of sustained ERK1 activation, ERK1 activity was blocked by the addition of PD98059 throughout G1. Addition of PD98059 up to 4 h after PDGF treatment decreased ERK1 activity to the levels found in growth-arrested IIC9 cells. Loss of cyclin D1 mRNA and protein expression was observed within 1 h after inhibition of the second sustained phase of ERK1 activity. Disruption of sustained ERK1 activity also resulted in G1 growth arrest. These data provide evidence for a role for sustained ERK activity in controlling G1 progression through positive regulation of the continued expression of cyclin D1, a protein known to positively regulate G1 progression.

Animals↗

Initiation of hormone replacement therapy after diagnosis of osteoporosis by bone densitometry.

The effect of osteoporosis, as diagnosed by bone densitometry, on general practitioners' decisions to initiate hormone replacement therapy (HRT) was assessed. Data for the study were collected by questionnaire from 147 women (> 40 years), previously referred for measurement of bone mineral density (BMD) at the proximal forearm. Among the women, at the time of BMD measurement, current and ever use of HRT was 35% and 50% respectively, and 25.2% were osteoporotic on the basis of their BMD level. HRT was more likely to be initiated by women who were told that their BMD was low (ODR 3.4; 95% CI 1.2-9.7); 37% of all women with osteoporosis were using HRT compared with 78% who were taking calcium supplements. Potential reasons for the low HRT prescription may include the nature of the BMD report, patient aversion to HRT and doctors' concern with the long-term side-effects of HRT.

Absorptiometry, Photon↗

Alternate site testing for HbA1c using the Primus CLC330 GHb analyzer.

OBJECTIVE: To determine whether the Primus high-pressure liquid chromatography (HPLC) is suited to alternate site testing (AST) for HbA1c in a hospital diabetes outpatient clinic. RESEARCH DESIGN AND METHODS: Patients were attending the clinic for routine management of their diabetes. A number of diabetic patients with uremia (n = 11) were also investigated. HbA1c levels were measured in the outpatient setting by the Primus HPLC and in a more limited study the DCA-2000 instrument using the new 6-min assay cartridge. HbA1c measurements were also performed with Pierce affinity minicolumns and a Bio-Rad Variant HPLC. RESULTS: The Primus HPLC assay had low imprecision of 2.3, 1.6, and 1.0% for HbA1c levels of 4.7, 7.3, and 11.1%, respectively, and was not prone to interference by carbamylated hemoglobin as found for the ion-exchange Variant HPLC method. Method comparison studies showed that the bias and proportional error between the Pierce affinity minicolumn procedure (standardized with respect to an external quality control program) and the Primus HPLC (Y) was -0.4 and 1.2% respectively (n = 32). Similarly the bias and proportional error between the Primus and DCA-2000 methods was 0.7 and -2.5%. The Primus was shown to give falsely elevated HbA1c concentrations if the time between sequential injections was > 28 min. CONCLUSIONS: The Primus HPLC has a decided advantage over specialty AST instruments, like the DCA-2000, in not only meeting AST requirements but also allowing rapid automated batch processing of all laboratory HbA1c samples.

Chromatography, Affinity↗

Type 2 diabetes.

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Amylases↗

A case of syndrome X.

Type 2 diabetes is increasing in prevalence and is predominantly managed in general practice. This series contains case histories which deal with some of the metabolic problems that may be encountered in the management of these patients and indicates some of the many issues, other than glycaemic control, that need to be considered.

Diabetes Mellitus, Type 2↗

Monitoring glucose control.

Type 2 diabetes is increasing in prevalence and is predominantly managed in general practice. This series contains case histories raising some of the metabolic problems which may be encountered in the management of these patients and indicates some of the many issues, other than glycaemic control, that need to be considered.

Blood Glucose Self-Monitoring↗

A cautionary tale.

Type 2 diabetes is increasing in prevalence and is predominantly managed in general practice. This series contains case histories raising some of the metabolic problems which may be encountered in the management of these patients and indicates some of the many issues, other than glycaemic control, that need to be considered.

Aged↗