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Biomedical subjects

P Phillips

Publications and source records attributed to P Phillips.

At least 199 records · Page 11Linked to original sources
PubMed1990

Assuring the quality of in-home care: the "other" challenge for long-term care.

Although the growth of in-home care has been praised for expanding long-term care options for people with chronic disabilities, questions surrounding the quality of in-home care have begun to arise. This paper discusses six critical factors that complicate efforts to assure quality including client and provider characteristics, fiscal constraints, inadequate regulation, lack of quality assurance methods, and lack of a coherent social policy for long-term care. A final section of the paper identifies three areas of policy to be addressed if efforts to deliver quality of care are to be successful.

Aged↗
PubMed1990

Nonvalue of antigen detection immunoassays for diagnosis of candidemia.

We evaluated the Cand-Tec (Ramco Laboratories Inc., Houston, Tex.) and LA-Candida antigen detection system (Immuno-Mycologics Inc., Norman, Okla.) tests as possible rapid alternatives to blood cultures for the identification of patients with candidemia. Tests were performed on sera from (i) 33 patients with candidemia, (ii) 82 patients with fever and risk factors for invasive candidiasis, and (iii) 13 healthy controls. A total of 21 patients had no evidence of invasive candidiasis, as determined by clinical course, blood culture, and/or autopsy; results for 61 patients were indeterminate regarding the presence of invasive candidiasis, or else the patients had invasive candidiasis with organ involvement. By using a threshold positive Cand-Tec titer of greater than or equal to 1:4, the sensitivity in candidemic patients was 49%; the specificity was 43% (patients with true-negative results had neither candidemia nor other evidence of invasive candidiasis). Coexistent disseminated candidiasis in some candidemic patients may have accounted for some positive Cand-Tec tests and possible overestimation of the sensitivity of the test for candidemia. Cand-Tec test results were negative for healthy controls. All test results obtained by the LA-Candida antigen detection system assay were negative. Our findings indicate that neither of these assays reliably identifies patients with candidemia.

Adolescent↗
PubMed1990

A self-advocacy plan for high school students with learning disabilities: a comparative case study analysis of students', teachers', and parents' perceptions of program effects.

This qualitative study examined immediate perceived effects of a self-advocacy plan for students with learning disabilities (LD) in a 4-year comprehensive high school. The study's design was based on information-processing theory and qualitative research techniques, such as participant/observation and interviews. Subjects were 15 ninth- and tenth-grade students with LD, their parents, and their resource teachers. Participants responded to standardized open-ended interview questions upon completing the first step of the Self-Advocacy Plan. The study suggests that the Self-Advocacy Plan is an effective program increasing students' awareness of the vocational and academic services they qualify for, clarifying their perceptions of their roles as learners and individuals with LD, increasing their understanding of LD as a condition that has certain general characteristics, and developing their awareness of career and educational opportunities. The study provides suggestions for future self-advocacy research and for special educators who wish to design programs for students with LD incorporating the concepts of psychosocial development of the individual, information-processing theory, and self-advocacy.

Adolescent↗
PubMed1990

Prevalence of Toxoplasma gondii antibodies in dingoes.

Serum samples from 62 dingoes (Canis familiaris dingo) trapped in five areas of southeastern New South Wales, Australia were tested for antibodies to Toxoplasma gondii. Six (10%) of the dingoes had direct agglutination test titers for T. gondii of greater than or equal to 1:64, and four of these animals had T. gondii-specific IgM, suggesting recent exposure.

Agglutination Tests↗
PubMed1989

Inotropic and lusitropic effects of MCI-154 (6-[4-(4- pyridyl)aminophenyl]-4,5-dihydro-3(2H)-pyridazinone) on human myocardium.

We studied the inotropic and lusitropic responses to MCI-154 in 12 right or left ventricular trabeculae carneae isolated from 7 organ donors (non-cardiac) without known cardiovascular disease who met accepted criteria for brain death. Isometric tension was recorded from muscles superfused with a physiologic salt solution at 30 degrees C, and stimulated to contract at three-second intervals. Concentration-response curves were developed over a range of MCI-154 organs bath concentrations (10(-7) M to 3 x 10(-4) M; n = 9). Six experiments were conducted using 10(-6) M carbachol, a muscarinic agonist, in the presence of a maximally effective concentration of MCI-154 to test for dependence of tension development on cyclic adenosine monophosphate. Three experiments were conducted with MCI-154, 3 x 10(-5) M, in muscles loaded with the bioluminescent calcium indicator aequorin. MCI-154 produced a concentration-dependent rise in peak tension in the human muscle (positive inotropic effect), equivalent to 70% of the maximal response to calcium (P less than 0.001). Relaxation was enhanced (positive lusitropic effect), as evidenced by a fall in the time to 80% relaxation from 311 +/- 13 ms (baseline) to 248 +/- 15 ms at 10(-5) M (P less than 0.01). Aequorin studies showed the increase in tension to be accompanied by large increases in cystolic calcium, the principal mechanism of action. Carbachol caused MCI-154--induced maximum peak tension to decrease by 5 +/- 1%. While not excluding a cyclic adenosine monophosphate--mediated MCI action, this modest carbachol inhibition suggests the existence of additional mechanism(s) of action. MCI-154 had a negative lusitropic effect at high concentrations (greater than 10(-4)M) which may have been due to intracellular calcium overload, evidenced by the large amplitude aequorin signals. This does not exclude sensitization of the myofilaments to calcium as a possibility. Extrapolated to the in vivo setting, these experiments suggest that MCI-154 may be an effective positive inotropic agent in man.

Aequorin↗
PubMed1989

Acute hormonal and renal effects of oral dilevalol in normal men.

1. Acute hormonal and renal effects of dilevalol (200 mg), a non-selective beta-blocking drug with vasodilator properties, were compared with placebo in six normal men on constant sodium intake. 2. Control and treatment blood pressures were lower with dilevalol than placebo, although the pattern of blood pressure fall was similar in both. 3. Plasma active renin and aldosterone concentrations were lower on dilevalol than placebo after 4 h of recumbency (P less than 0.05). 4. Total plasma renin, renin substrate, cortisol and atrial natriuretic peptide concentrations were similar on dilevalol and placebo. 5. There were no differences in glomerular filtration rate and no deleterious biochemical or haematological changes on dilevalol or placebo.

Administration, Oral↗
PubMed1989

Protein kinase inhibitor prevents pulmonary edema in response to H2O2.

We investigated the effect of H2O2 (92 microM) in isolated guinea pig lungs perfused with a buffered Ringer solution. Pulmonary arterial pressure (Ppa), pulmonary capillary pressure (Ppc), and change in lung weight (delta W) were recorded at 0 min and at 15, 30, and 60 min after the H2O2. The capillary filtration coefficient (Kfc) was measured at 0 and 30 min. The perfusion of H2O2 increased the Ppa, Ppc, delta W, and Kfc. The thromboxane synthetase inhibitor Dazoxiben, or the vasodilator papaverine, prevented the increases in Ppa and Ppc. The protein kinase C (PKC) inhibitor H7 [1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride] prevented the increases in Ppa, Ppc, delta W, and Kfc, whereas the inactive isoquinoline HA1004 [N-(2-guanidinoethyl)-5-isoquinolinesulfonamide hydrochloride] had little effect on the H2O2 response. H2O2 increased the number of stress fibers and disrupted the peripheral band of cultured confluent endothelial cells, changes that were prevented with pretreatment with H7. PKC may mediate the increases in vascular permeability and pulmonary edema that occur in response to H2O2.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
PubMed1988

Comparison of alprazolam plasma levels in normal Asian and Caucasian male volunteers.

Single-dose pharmacokinetics of alprazolam was studied in 42 normal male volunteers (14 Caucasians, 14 American-born Asians, and 14 foreign-born Asians), after both oral and parenteral (IV) administration of a small dose (0.5 mg) of the test drug. Asians manifested significantly higher Cmax, larger AUC, slower CL and longer t1/2 under both testing situations. When body surface area was used as a covariate, these cross-ethnic differences remained statistically significant (except Cmax) after oral but not IV drug administration. There were no differences between the two Asian groups in any of these parameters examined in this study. These results confirmed previous observations of ethnic differences in the pharmacokinetic response between Asians and Caucasians and suggested that smaller doses of alprazolam may be required for Asians for similar clinical effects as compared to their Caucasian counterparts.

Administration, Oral↗
PubMed1988

Segregation of lymphocyte low-molecular-weight DNA and antinuclear-antibodies in a family with systemic lupus erythematosus in first cousins.

All patients with systemic lupus erythematosus (SLE) demonstrated two classes of newly synthesized DNA in sucrose density gradients of PHA (phytohemagglutinin)-stimulated lymphocytes: a large-molecular-weight fraction that comigrates with control DNA and an excess low-molecular-weight DNA (LMW-DNA) fraction not found in control lymphocytes. Excess LMW-DNA was independent of disease activity or drug therapy. LMW-DNA and serologic abnormalities were studied in a four-generation family in which two first cousins had SLE. Excess LMW-DNA was found in the cousins with SLE, sibling parents of the SLE patients, a common grandparent, four of nine siblings of one patient, and five of seven at risk children. Both males and females had excess LMW-DNA. Male-male transmission was observed. The expression of excess LMW-DNA in stimulated lymphocytes is inherited as an autosomal dominant genetic trait in this family. All unaffected adult family members with the marker had positive antinuclear antibodies (ANAs) except the grandmother. However, none of the five children with excess LMW-DNA showed positive ANAs. Excess LMW-DNA precedes the appearance of ANAs when found in children of adults with excess LMW-DNA, and may be a predisposing factor in the development of the immunologic responses of systemic lupus erythematosus.

Antibodies, Antinuclear↗
PubMed1988

Measurement of intraocular lens decentration and tilt in vivo.

A method for measuring the tilt and decentration of intraocular lenses (IOLs) in the static eye using the Purkinje image locations is presented. The patient fixates on a target that is coaxial with the camera or is at a predetermined angle with the camera axis. A telecentric stop is introduced in the camera so the positions of the Purkinje images on the film are independent of their distance from the camera. Measurements of the image locations on the film are used with anterior chamber depth and corneal curvature measurement to calculate the tilt and decentration of the IOL. In a group of 14 randomly selected patients with posterior chamber IOLs, 13 gave Purkinje images that could be measured. The average tilt was 7.8 degrees and the average decentration was 0.7 mm.

Humans↗
PubMed1987

Psychological problems associated with diagnosis and treatment of lymphomas. I: Retrospective study.

Patients treated for Hodgkin's disease and non-Hodgkin's lymphoma have a better prognosis than other patients with cancer so may have a lower prevalence of psychological and social morbidity. Trained interviewers used standardised methods to assess 90 patients at a mean of 32 months after the diagnosis of Hodgkin's disease or non-Hodgkin's lymphoma. Chemotherapy and radiotherapy had commonly caused adverse effects including hair loss, vomiting, nausea, and loss of appetite. Although most patients were free of disease and not receiving treatment at follow up, some still suffered from a lack of energy (31 patients), loss of libido (19), irritability (22), and tiredness (19); 30 patients complained of continued impairment of thinking or disturbance of short term memory. After diagnosis 21 patients had suffered from an anxiety state or depressive illness, or both, while 27 had experienced borderline anxiety or depression, or both. Mood disturbance was positively correlated with adverse effects of treatment, particularly those affecting the gastrointestinal tract. Social adjustment was less affected, but failure to return to work, or a long delay in returning to work, and a persistent lack of interest in leisure activities gave cause for concern. These findings of substantial psychiatric and social morbidity in patients with Hodgkin's disease and non-Hodgkin's lymphoma prompted a prospective study of these patients to determine their nature and duration.

Adolescent↗
PubMed1987

Psychological problems associated with diagnosis and treatment of lymphomas. II: Prospective study.

A prospective study of 120 patients newly diagnosed as having Hodgkin's disease and non-Hodgkin's lymphoma was conducted to determine the nature, extent, and timing of the psychiatric and social morbidity associated with the diagnosis and treatment. Patients were interviewed at diagnosis and two, six, and 12 months later by trained interviewers using standardised questionnaires. Psychiatric morbidity was greatest in the three months before treatment, but new episodes of anxiety and depression developed throughout the year of follow up. Altogether 39 patients suffered a depressive illness or anxiety state, or both, and a further 37 experienced borderline anxiety or depression, or both, during the 15 months of assessment. The most common adverse effects of treatment were hair loss, nausea, vomiting, sore mouth, and changes in perception of taste. Toxicity of treatment was associated with psychiatric morbidity. Conditioned responses to chemotherapy were experienced by 32 patients. Social morbidity was low, although difficulties in returning to work and to previous levels of leisure activity were noted. Although most patients were no longer receiving treatment and were free of disease at the one year follow up, 51 patients continued to complain of loss of energy, 24 of loss of libido, 38 of tiredness, 23 of irritability, 18 of poor concentration, and 23 of memory impairment. These results confirm our retrospective study and suggest that a high price is paid for long term survival by a substantial proportion of patients receiving treatment for Hodgkin's disease and non-Hodgkin's lymphoma.

Adult↗