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Biomedical subjects

R B Phillips

Publications and source records attributed to R B Phillips.

At least 55 records · Page 3Linked to original sources

Plain film radiology in chiropractic.

The use of plain film radiography in the early stages of acute low back pain has been challenged. Health care providers who maintain their own radiological services tend to charge more and take more X-rays than those who refer patients out for such services. Chiropractic physicians generally own their own X-ray equipment and see a predominance of low back pain in practice. There is a basis for unjustified utilization of X-ray. The chiropractic physician justifies the use of X-ray in the management of low back pain to a) rule out pathology, b) perform a biomechanical evaluation, c) protect against medicolegal action, d) obtain financial gain and e) out of habit. The literature fails to support or justify the use of X-ray in the management of acute low back pain for any of the above listed reasons. Arguments to this effect are presented. A guidelines is provided as a suggestion for improved decision making regarding the use of X-ray in the low back patient. A challenge is issued to the practitioners who treat low back pain to seek better justification for their current practice patterns.

Age Factors↗

Cost per case comparison of back injury claims of chiropractic versus medical management for conditions with identical diagnostic codes.

This study assessed the total cost per case of chiropractic claims and medical claims for conditions with identical diagnostic codes. The sample consisted of 3062 claims or 40.6% of the 7551 estimated back injury claims from the 1986 Workers' Compensation Fund of Utah. For the total data set, cost for care was significantly more for medical claims, and compensation costs were 10-fold less for chiropractic claims.

Adult↗

Osteopathic vs. chiropractic education: a student perspective.

This study compares nationwide survey results from 506 second year students of 11 osteopathic schools and 881 students from the first and second academic year (third term/fourth quarter) of eight chiropractic colleges. Each student was given a questionnaire regarding his/her perspective on the education he/she was receiving. Both populations were questioned about whether or not they came from an osteopathic/chiropractic family, their application process, the efficacy of osteopathic manipulative therapy (OMT)/chiropractic adjustments, their first year attitude concerning the efficacy of OMT/chiropractic adjustments, the integration of osteopathic/chiropractic principles into the curriculum and the justification for separate health care professions. Osteopathic and chiropractic students entered their respective professions from nonosteopathic/non-chiropractic families. Although both populations selected their profession as a first and primary choice, chiropractic students were more substantially represented. Upon entering their program, osteopathic students were not convinced, but had an open mind concerning the effectiveness of osteopathic manipulative therapy (OMT), and were divided as to whether there is enough of a distinction between DOs and MDs to justify separate professions. Chiropractic students, on the other hand, entered their program convinced that chiropractic adjustments are effective, and saw a clear distinction between the roles of chiropractic physicians and medical doctors.

Attitude↗

Reliability of manual muscle testing with a computerized dynamometer.

The purpose of this study was to investigate the reliability of manual dynamometry. Three testers participated and performed the doctor- and patient-initiated testing methods as described in the applied kinesiology literature. Three muscles from each subject were tested. Fifteen normal volunteer adults had their muscles tested by the doctor-initiated method and another 15 had their muscles tested by the patient-initiated method. Each tester took two observations per muscle. The testing procedures were repeated 7 days later. The results showed that the intratester reliability coefficients were 0.55, 0.75 and 0.76 for testers 1, 2 and 3, respectively, when the doctor-initiated method was used; 0.96, 0.99 and 0.97 when the patient-initiated method was used. The intertester reliability coefficients were 0.77 and 0.59 on day 1 and day 2, respectively, for the doctor-initiated method; 0.95 and 0.96 for the patient-initiated method. It is concluded that manual dynamometry is an acceptable procedure for the patient-initiated method and is not acceptable for the doctor-initiated method.

Adult↗

A comparison of patients and patient complaints at six chiropractic college teaching clinics.

A cooperative study was undertaken by six chiropractic colleges for the purpose of studying similarities and/or differences among the patients and patient complaints at the college outpatient (teaching) clinics. There were some notable differences among the clinics with respect to the standard demographic variables of age, education, employment and income. The sociodemographic characteristics of patients appeared to be different to the extent that the characteristics of the neighborhoods in which the clinics were located were different. Patients referred to the clinics by chiropractic student/interns were more likely to attend for routine physical exam than patients referred by other sources. Although marked differences were observed in patient attendance for routine physical examination, the health problems for which patients sought treatment were very similar among all the clinics. Low back complaints were the most frequently reported health complaint. The characteristics of the low back complaints were very similar at all six sites.

Ambulatory Care Facilities↗

Omovertebral bone.

A case of unilateral Sprengel's deformity with an associated omovertebral bone is presented. A review of proposed mechanisms of development is included in the discussion of this rare anomaly. The condition is largely one of cosmetic deformity rather than signs and symptoms. The significance of identifying it's presence lies in uncovering the many less obvious, but more potentially serious, anomalies that may be associated with it. Conservative management is discussed.

Adult↗

Chiropractic in the yellow pages: a content analysis study.

This paper presents a content analysis of advertisements by chiropractors in the yellow pages. Information was gathered from 13 cities in the United States for the years 1985 and 1986. Results were categorized by size, number and content of the ads. Estimated expenditures for each city were calculated and a total cost for advertising for the entire chiropractic profession was estimated. Of the 5456 chiropractors listed in the yellow pages in this study, 14.7% bought additional space in the regular listing section, and 11.6% purchased large display advertisements. The remaining 73.7% listed only their name and telephone number. Of those who bought additional space, 10.8% advertised techniques, 11.6% symptoms, 14.7% injuries, 3% professional affiliations and 4% advertised free services. The average annual expenditure for the chiropractor was $2474.00. Future research needs to address the attitudes of the profession and patients toward advertising, and the cost-effectiveness of advertising. The value of the distribution of resources for advertising by chiropractors is questioned.

Advertising↗

A comparative analysis of the interpretations of lumbar spinal radiographs by chiropractors and medical doctors.

Ninety-nine anteroposterior and lateral lumbar radiographs taken of men, 18 to 55 years of age, were randomly selected from participants in a population survey of low-back pain. Thirty-one (31%) had never had low-back pain; 44 (44%) had or were having mild low-back pain; and 24 (24%) had or were having severe low-back pain. Three chiropractors assessed 56 radiographic variables, which included determinations of disc space height, vertebral malalignments and subluxations, spondylosis, postural disturbances, relationships among pelvis and spine and other congenital or acquired abnormalities. Interobserver reliability measurements showed that 6 of the 56 variables analyzed produced a high interobserver reliability. Sixteen additional variables showed a fair interobserver reliability. Comparison of the observations made by the chiropractors and a radiologist showed minimal agreement except for disc space height assessments at L3-4 and L4-5. Few of the radiographic variables discriminated between the current or prior history of low-back and leg complaints, although a few variables (most notably disc space narrowing) were statistically associated with back or leg complaints (P = .025). The conclusion was reached that spinal radiographs, whether analyzed by measurements, by a radiologist, or by chiropractors, have minimal value in determining the presence or absence of low-back complaints and, in particular, have no value in epidemiologic studies.

Adult↗

Chromosome banding in salmonid fishes: nucleolar organizer regions in Oncorhynchus.

Chromosome banding patterns obtained by silver staining and chromomycin a3 (CMA3) staining were analyzed in six species of Oncorhynchus: O. tshawytscha, O. kisutch, O. keta, O. nerka, and O. gorbuscha from North America and O. masou from Japan. Four different chromosomal locations of the nucleolar organizer regions (NORs) were found in different species. In O. tshawytscha, O. kisutch, and O. masou the NORs comprised the entire short arms of one medium-sized acrocentric chromosome pair. In O. nerka the NORs were found in an interstitial band on the short arms of one submetacentric chromosome pair and in O. gorbuscha proximal to the centromere on one metacentric chromosome pair. In O. keta the NORs were found on the telomeres of one small submetacentric chromosome pair. As in the related genera Salmo and Salvelinus chromomycin A3 positive bands were found at the same sites as the AgNORs in all species. Salmonid fish are assumed to be ancestral tetraploids and the considerable differences in chromosome number between different species are thought to be the result of chromosomal fusions after tetraploidization. In all members of the genus Oncorhynchus the rearrangements have resulted in the consolidation of the NORs on a single chromosome pair. The possible significance of intra- and inter-species NOR polymorphisms is discussed.

Animals↗

Low back pain: a radiographic enigma.

Ninety-nine anteroposterior and lateral lumbar radiographs taken of males ages 18-55 were independently analyzed by three chiropractors who assessed 56 variables, including determinations of disc space height, vertebral malalignments and subluxations, spondylosis, postural disturbances, relationships between pelvis and spine, and other congenital or acquired abnormalities. The distribution of low back complaints in this study included 31% with no low back pain, 44% with previous or present mild low back pain and 24% with previous or current severe, and often disabling, low back pain. Determinations were made of interobserver reliability between the three chiropractors and a medical radiologist. Of the 56 radiographic variables assessed by the chiropractors, six demonstrated a high interobserver reliability. In general, the best reliability was for variables that were actual measurements, rather than subjective observations. Sixteen additional variables demonstrated a fair interobserver reliability. Comparison of the observations between a radiologist and the chiropractors showed correlations in their assessments of disc space height at L3-4 and L4-5; otherwise, there was poor interobserver reliability. Few of the radiographic variables were found to be reliable predictors of present or prior history of low back and leg complaints. A few variables (most notably disc space narrowing) were statistically associated with back or leg complaints (P = 0.025). We conclude that spinal radiographs, whether analyzed by measurements, by a radiologist or by chiropractors, have minimal value in predicting the presence or absence of low back complaints and, in particular, have no value in epidemiological studies.

Adolescent↗

The ribosomal RNA genes of three salmonid species.

The ribosomal RNA cistrons of three species of trout: Salvelinus namaycush (lake trout), Salvelinus fontinalis (brook trout), and Salmo gairdneri (rainbow trout) were examined by Southern blot analysis of genomic DNA. The repeat length of the cistron of S. namaycush is 26 kb. A repeat-length polymorphism was observed in some of the individual fish examined. These individuals showed 24-kb repeats. In some individuals both forms were present. The restriction maps of the transcribed regions of all three species were similar and showed a site homology with other vertebrate ribosomal RNA genes. Interspecific comparison showed restriction-site differences within the spacer regions examined. A restriction-site polymorphism within the 28 S gene was observed in S. fontinalis. The rDNA of S. namaycush liver showed a high degree of methylation as determined by digestion with the restriction endonucleases MspI and HpaII.

Animals↗

Identification of sex chromosomes in lake trout (Salvelinus namaycush).

In the male trout there is a difference in the quinacrine banding and C-banding patterns between the two homologs of the second largest chromosome pair. This chromosome is the only large submetacentric in the karyotype, making it easy to identify and suggesting that the sex chromosomes have become differentiated since the time of tetraploidization. In males one homolog has a medium-to-large quinacrine bright heterochromatic band on the end of the short arm, while the other lacks it completely. In females both homologs have medium-to-large quinacrine bright heterochromatic bands. Approximately half the progeny from every lake trout cross studied and half the eggs from every lake trout population examined were heteromorphic for a difference in this chromosome band. Results from sexed fish, reciprocal F1 hybrids between brook trout and lake trout, and gynogenetic haploids are all consistent with the interpretation that chromosome 2 is the sex chromosome. These results suggest that the addition of heterochromatin to the X can be the first step in the inhibition of crossing over between the X and Y chromosomes required for sex chromosome differentiation.

Animals↗

Analysis of S-35 labeled WR-2721 and its metabolites in biological fluids.

Studies with WR-2721 and related compounds have been hindered by the lack of a suitable assay for the drug and its major metabolites. We have developed a chromatographic method which requires no derivatization for the separation and detection of WR-2721, the free thiol, its symmetrical disulfide and other mixed disulfides. Our procedure involves ion-pairing for separation of ionizable compounds by causing polar molecules to become more lipophilic and hence separable using reverse phase HPLC. Detection is based upon liquid scintillation counting of S-35 incorporated during the synthesis of the parent compound. This method requires no pre-column preparation of samples and, by detecting the S-35 label, eliminates the chance that a coeluting species could interfere with detection, as might occur with post-column derivatization. Chromatography was done using a 10 micron C8RP column and 35% MeOH/65% 0.0113M NaH2PO4, 0.005 M hexanesulfonate, pH 5.9, flowing at 1 ml/min. Half-minute fractions were collected into scintillation vials for counting. Retention volumes for the various compounds were: column breakthrough (3.5 ml), WR-2721 (4.5 ml), WR-1065 (9 ml), and WR-33278 (24 ml). This analytical technique employing radiotracers can be used to study radioprotective mechanisms by time dependent measurements of the tissue distribution and chemical form of labeled drug. Such chemical information can then be correlated with biological measures of radiation protection.

Amifostine↗

A linkage study of the HLA region using C-band heteromorphisms.

A linkage study was performed to establish the map distance from the HLA region to the centromere on 6p. In this study, seven families were investigated for the segregation of their HLA types and a polymorphic C-band marker on chromosome 6. Four out of 29 children were found to be recombinants. A map distance of 14 cM was determined. Ninety-five percent confidence limits for the recombination frequency were established (0.012 less than or equal to theta less than or equal to 0.263).

Chromosome Banding↗

Efficient photochemical formation of 1 alpha-hydroxyprevitamin D3.

Control of the band width of the irradiating light between 280 and 310 nm and of the temperature of the reaction permits formation of 1 alpha-hydroxyprevitamin D3 in yields of over 80%, at 40-60% conversion of the 1 alpha-hydroxyprovitamin D3. The procedures developed permit doubling the photochemical yield of the 1 alpha-hydroxyvitamin D3 compounds which are the major circulatory forms of vitamin D3.

Hydroxycholecalciferols↗

Q band chromosomal polymorphisms in lake trout (Salvelinus namaycush).

Q banding of chromosome preparations from lake trout revealed the presence of heteromorphic quinacrine bright bands on several chromosomes. All of the metacentric chromosome pairs can be distinguished on the basis of number, position and intensity of the quinacrine bright bands and chromosome size. These bands appear to represent heterochromatin, since they are darkly staining with the C band technique. Since all of the fish examined had consistent heteromorphisms at several of the quinacrine bright bands, these chromosome markers should be useful in genetic comparisons between different trout stocks and populations.

Animals↗

Survey of chiropractic in Dade County, Florida.

This survey of the members of the Dade County Chiropractic Society of Miami, Florida was initiated with the encouragement and under the supervision of the Dade County Health Systems Agency (HSA). The purpose of the survey was to obtain information relative to the inclusion of chiropractic into future health planning to be conducted by the HSA. The survey was divided into a "Physicians Survey" obtaining information on location, office hours, gross income, total patient visits and type of practice of the doctor, and a "Patient Survey" obtaining information on age, sex, ethnic origin, residence, and payment source of the patients. Clinical information on initial complaints, diagnoses, treatment, referrals, and amount of care was also obtained. It was found that chiropractors work an average of 31.7 hours per week with a gross annual income of $74,750.00 (1979). The male-female distribution of patients was equal and the average patient age was 43.4 years. Anglocaucasian category comprised 80.2% of the patient sample. Nearly 50% of all chiropractic patients pay for services rendered out of their own pocket. Of the primary diagnosis, 81.3% related to the spine. The study concludes that the practice of chiropractic in Dade County is very similar to the practice of chiropractic in general.

Chiropractic↗