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Biomedical subjects

P Phillips

Publications and source records attributed to P Phillips.

At least 19 recordsLinked to original sources
PubMed1992

Spectrum of tuberculosis in patients with HIV infection in British Columbia: report of 40 cases.

OBJECTIVE: To review the clinical features, treatment and outcome of all known cases of tuberculosis in patients with human immunodeficiency virus (HIV) infection in British Columbia between 1984 and 1990. DESIGN: Retrospective case review. SETTING: Provincial tuberculosis registry and university-affiliated HIV clinic. PATIENTS: All people with HIV infection in whom active tuberculosis was diagnosed during the study period. RESULTS: All 40 patients identified were men; their mean age was 38 years. Of the subjects 30 (75%) were homosexual, 6 (15%) were homosexual and used intravenous drugs, 2 (5%) just used intravenous drugs, and 1 (2%) had had heterosexual contact with prostitutes; for the remaining subject the risk factor for HIV infection was not established. In all cases cultures of specimens from 15 body sources yielded Mycobacterium tuberculosis. Thirty-five of the patients had acquired immunodeficiency syndrome (AIDS), and five had HIV infection uncomplicated except for tuberculosis. In 28 (70%) of the cases no AIDS-defining disease had previously been diagnosed, and in 23 (58%) extrapulmonary tuberculosis represented the AIDS-defining disease. Symptoms at presentation included weight loss (in 80% of the cases), fever (in 75%), cough (in 70%) and night sweats (in 55%). The mean CD4 lymphocyte count was 0.2 x 10(9)/L (in 15 cases). Tuberculin skin test results were positive in 8 of 16 cases. The most striking radiologic finding was intrathoracic adenopathy. All except one of the 36 patients who received appropriate treatment responded favourably at first. Adverse reactions necessitating changes in treatment occurred in 12 (33%) of the cases. Relapse occurred after completion of therapy in two cases (one at 3 weeks and the other at 9 months after treatment was stopped). Tuberculosis was the cause of death in five cases. CONCLUSIONS: Tuberculosis in people with HIV infection commonly presents as extrapulmonary disease and precedes or coincides with other AIDS-defining opportunistic infections. In most cases tuberculosis is the AIDS-defining disease. Even though radiologic findings are often unusual physicians should suspect tuberculosis. A careful examination for evidence of disease at multiple sites should be done. The duration and choice of therapy must be adequate to avoid relapse.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Isolation of koala lymphoid cells and their in vitro responses to mitogens.

Baseline parameters have been established for the successful in vitro culture of mononuclear cells from the peripheral blood (PMC) of koalas. To minimise stress-related influences and allow repeated testing of cells from the same animals, most studies were performed using blood samples from captive koalas which had become accustomed to regular handling. Ficoll-Paque density gradient fractionation of whole blood was required to prepare cell suspensions which responded well to the T-lymphocyte mitogens phytohaemagglutinin, concanavalin A and pokeweed mitogen. In contrast, very low or negligible proliferative responses were induced by the B-lymphocyte mitogens lipopolysaccharide, jacalin and protein A, even when purified PMC were cultured with a wide range of concentrations of these molecules. Using the standard approaches established with T-lymphocytes of eutherian animals, it was shown that concanavalin A-stimulated PMC produced an interleukin 2-like growth factor. The significance of these findings is discussed in the context of current knowledge and understanding of similar studies carried out using the lymphoid cells of eutherian and other metatherian animals.

Animals↗
PubMed1992

Reliable identification of human albumin in ancient bone using ELISA and monoclonal antibodies.

In order to help reconstruct ancient dietary, domestic, and ritual behaviour, a method was developed to identify the blood protein albumin in ancient skeletal material. This was an inhibition enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody of IgG class against human albumin. With fresh material, the technique gave consistent and specific results and could detect as little as 10 ng of albumin. Extracts of bone from the English Civil War (A.D. 1644), Mediaeval (A.D. 1100-1400), Early Saxon (A.D. 450-600), Roman (A.D. 100-200), Iron Age (ca 400 B.C.) and Bronze Age (2200-1700 B.C. cal.) periods were then tested, samples of fresh human and animal bone being included as positive and negative controls, respectively. Albumin was demonstrated in human bone from all periods; there was no evidence of cross-reactivity with animal material. Detection seemed to depend largely on amount of sample and chronological age; other factors, such as physical integrity of the specimen and soil characteristics, appeared to be less important. Preliminary studies of other ancient skeletal remains showed that animal species could be readily identified and that albumin was probably still detectable in cremated material. It is concluded that our method provides a tool specific and sensitive enough for the reliable identification of the species-origin of small fragments of bone (and possibly of blood stains) and will thus allow insight into past behaviour patterns. ELISA may also be suitable for identifying other molecules (such as HLA and ABO) which would help determine racial affiliation and disease predisposition among ancient populations.

Albumins↗
PubMed1992

Detection of human proteins in buried blood using ELISA and monoclonal antibodies: towards the reliable species indentification of blood stains on buried material.

The survival of human proteins in blood stains on fragments of cloth buried in exposed soil was examined in a 15-month investigation carried out from September 1990 to December 1991. During this period there was a wide variety of weather conditions. Samples were exhumed at 4-weekly intervals for 16 weeks and finally at 65 weeks; extracts of the stains were tested for albumin and IgG using a highly specific and sensitive enzyme-linked immunosorbent assay (ELISA) performed with monoclonal antibodies. Human albumin survived well throughout the 15 months of study, but IgG could be detected only in the 4- and 8-week samples. The reactions for IgG were weaker than those for albumin, although the method's sensitivity (10 ng) was the same for each protein. Appropriate buried and non-buried control experiments were carried out using cloth, either unstained or stained with human blood or animal sera; there was no cross-reactivity between human and the other species investigated and soil did not affect the assay; under laboratory conditions, IgG and albumin survived equally well. The system's versatility was illustrated by using monoclonal anti-bovine-albumin to detect specific albumin in the extracts of buried cloth which has been stained with bovine serum. It was concluded that ELISA performed with monoclonal antibodies could be of great value in identifying blood stains for forensic purposes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Comparison of the pharmacokinetics and pharmacodynamics of perindopril, cilazapril and enalapril.

1. The pharmacokinetic and pharmacodynamic responses to enalapril, perindopril and cilazapril have been studied in essential hypertensives (2, 4 and 8 mg perindopril and 2.5 mg cilazapril, single dose and steady state) and normotensive volunteers (10 mg enalapril, single dose). 2. Plasma levels of the active diacid compounds reached similar peaks after single dose administration of the drugs. However, perindoprilat levels persisted for 5 days whereas cilazaprilat levels were not detectable beyond 12 h. 3. The higher levels of perindoprilat were associated with a greater inhibition of plasma angiotensin-converting enzyme (ACE) activity in both acute and steady state studies. 4. The potency of the active diacids in inhibiting plasma ACE activity was perindoprilat greater than cilazaprilat greater than enalaprilat. 5. There was a close relationship between plasma concentration, ACE inhibition and blood pressure decrease. Although both cilazapril and perindopril administration reduced blood pressure in hypertensive subjects, only perindopril exerted 24 h blood pressure control at the doses used.

Adult↗
PubMed1992

Midline supratentorial tumors.

Tumors of the supratentorial midline are common in children and are often amenable to an aggressive operative resection. MR imaging is invaluable to planning an operative strategy. A variety of surgical corridors provide access to the deep midline structures, notably the transcallosal, transventricular, and basal routes. The histology is important in determining the value of adjuvant treatments, such as radiation therapy and chemotherapy. These complex tumors are best managed by a multidisciplinary group with a special interest in pediatric neuro-oncology.

Cerebral Ventricle Neoplasms↗
PubMed1992

Home dobutamine.

Explore the source record for details and available documents.

Dobutamine↗
PubMed1992

The effect of two intraoperative heat-conserving methods on orthopedic patients receiving regional and general anesthesia.

Postoperative hypothermia is a serious complication of surgery. The best way to prevent postoperative hypothermia is to prevent perioperative heat loss. The purpose of this study was to compare the efficacy of Thermadrape (O.R. Concepts, Inc., Roanoke, TX), a heat-retaining surgical covering, with cotton blankets in maintaining core body temperature for patients receiving general or regional anesthesia. One hundred seventeen patients having hand, wrist, or elbow surgery were covered with either cotton blankets or Thermadrape covering throughout the perioperative period. Core body temperature was measured using a tympanic membrane device (FirstTemp, Intelligent Medical Systems, Carlsbad, CA) preoperatively, on PACU admission, and at discharge. Thermadrape covering and cotton blankets were equally effective in conserving body heat. Patients receiving general anesthesia were cooler on PACU admission than those receiving regional anesthesia, regardless of the type of covering. Hospital decisions regarding choice of perioperative heat conservation interventions will be guided by the cost of the intervention as well as efficacy. If overall hospital cost of cotton blankets is greater than that associated with Thermadrape covering, a decision to use Thermadrape covering may be warranted. Important factors for consideration in future research are presented and discussed.

Anesthesia, Conduction↗
PubMed1991

Senescent human fibroblasts have a post-transcriptional block in the expression of the proliferating cell nuclear antigen gene.

The product of the proliferating cell nuclear antigen (PCNA) gene is the co-factor of DNA polymerase delta, which is required for cellular and viral DNA replication. Its steady-state mRNA levels are growth-regulated in young human diploid fibroblasts (HDF) as well as in many other cell types. In senescent HDF, PCNA mRNA is not detectable. However, the PCNA gene is transcribed in senescent HDF as efficiently as in young cells. Furthermore, PCNA hnRNA is easily detectable by reverse transcriptase-polymerase chain reaction in both senescent and young HDF, and the levels are essentially similar. These results indicate that in senescent HDF which are incapable of synthesizing cellular DNA, one of the genes coding for a protein of the DNA-synthesizing apparatus is still transcribed, but the product fails to be processed into mature mRNA.

Cell Cycle↗
PubMed1991

Relationship between ambulatory blood pressure and albuminuria in normal subjects.

Elevation of the urinary albumin excretion rate (AER) may be an important marker of vascular disease in nondiabetic as well as diabetic patients. Although hypertension is associated with an elevated AER, little is known regarding the relationship between AER and blood pressure in normal subjects. We studied 13 healthy, normotensive, nondiabetic subjects over 48 h. Urine was collected every 2 h and blood pressure was measured half hourly during the day using an ambulatory sphygmomanometric device. Overnight, blood pressure was measured hourly and a single overnight urine collection was obtained. Daytime blood pressures were higher than those overnight for systolic (122 +/- 9 v 105 +/- 8, P less than .01), diastolic (122 +/- 9 v 105 +/- 8, P less than .01) and mean arterial pressures (92 +/- 7 v 78 +/- 6 mm Hg, P less than .01). Similarly, AER fell overnight [day 5.9 (3.8 to 9.5) v night 3.6 (2.3 to 5.2) micrograms/min, median (interquartile range), P less than .01]. In the majority of subjects there was a significant positive correlation between AER and systolic (N = 9), diastolic (N = 10), and mean (N = 10) arterial pressure. We conclude that systemic blood pressure may influence AER in normal subjects.

Adult↗
PubMed1991

Herpes simplex hepatitis in a patient with psoriatic arthritis taking prednisone and methotrexate. Report and review of the literature.

Herpes simplex hepatitis is a rare disease in adults and with high mortality (81%). Most cases are seen in immunocompromised hosts or in the third trimester of pregnancy. A 43-year-old woman with psoriatic arthritis, treated with prednisone and methotrexate (MTX), presented with an acute abdomen and elevated liver enzymes. The diagnosis was made by liver biopsy. MTX was stopped and acyclovir was started. The patient survived. The diagnosis of Herpes simplex should be suspected in immunocompromised hosts and established by liver biopsy and viral cultures. Treatment includes parenteral acyclovir and discontinuation or reduction of immunosuppressive therapy.

Adolescent↗