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Biomedical subjects

S Phillips

Publications and source records attributed to S Phillips.

At least 181 records · Page 10Linked to original sources
PubMed1988

The direct medical costs of osteoporosis for American women aged 45 and older, 1986.

Annual direct medical costs of osteoporosis incurred by American women aged 45 and older are estimated at $5.2 billion in 1986. Costs are stratified by type of care (inpatient hospital, nursing home and outpatient) and by age group (ages 45 to 59, 60 to 74 and 75 and older). Survey data from the National Center for Health Statistics are combined with census data to project utilization estimates from the survey years to 1986. A portion of all health care encounters for diagnoses secondary to osteoporosis are considered to be caused by osteoporosis according to age- and diagnosis-specific attribution weights. These weights are derived from the opinion of a panel of osteoporosis experts. For inpatient hospitalization, the assigned diagnosis related group (DRG) is used to further specify osteoporosis as the cause of hospitalization. The cost components of osteoporosis care for American women in 1986 are inpatient care, $2.8 billion; nursing home care, $2.1 billion; and outpatient care, $0.2 billion. Study results suggest considerable potential future cost-savings of osteoporosis prevention and abatement.

Age Factors↗
PubMed1988

The effects of glucagon and glucagon-(1-21)-peptide on antroduodenal motility in healthy volunteers.

Since it has been argued that the spasmolytic effect of glucagon is related to the first 21 N-terminal amino acid residues, and not to the complete molecule, we have compared the effects of glucagon-(1-21)-peptide (G-(1-21) and glucagon on human antroduodenal motility. Glucagon and G-(1-21) were given as bolus injections to 30 healthy volunteers equally allocated into five groups. Each subject received two doses; one was placebo, 0.25, 0.5, 1.0 or 2.0 mg of glucagon, the other was an equimolar doses of G-(1-21) (placebo, 0.175, 0.35, 0.70 or 1.4 mg of G-1-21). The first injection was given during phase II of a migrating motility complex (MMC), and the next during the following phase II. Contractile activity was recorded using an oral tube with one sidehole positioned in the antrum and two in the duodenum. We confirmed that glucagon decreases the number of contractions in the antrum and duodenum and that normal phase II activity was restored within 20-40 minutes proportionally to the amount of the drug given. G-(1-21) did not change antroduodenal motility nor did it affect the phase II pattern in any of the groups. Neither were any side effects encountered. G-(1-21) does not seem to be an alternative to glucagon and other spasmolytic drugs for obtaining relaxation of the antroduodenal area.

Adult↗
PubMed1987

Basal forebrain infarction. A clinicopathologic correlation.

Following the repair of a ruptured anterior communicating artery aneurysm, a patient had a severe anterograde amnesia with sparing of other intellectual functions, apathy and loss of volition, altered arousal, and partial diabetes insipidus. Postmortem examination of the brain revealed bilateral destruction of the septal gray, nucleus accumbens, and nucleus of the diagonal band of Broca. Also involved in the lesion were inferior portions of the anterior limb of the internal capsule and globus pallidus. Discrete, microinfarcts were present in the paraventricular hypothalamic gray. Long-term therapy with desaminoarginine vasopressin nasal spray had no effect on the patient's neuropsychologic deficits.

Adult↗
PubMed1987

The Montana Fetal Genetic Pathology Program and a review of prenatal death in humans.

Western medicine is being sensitized to the enormous extent of prenatal death in humans at a time when such deaths, occurring after the first missed period, involve to an ever increasing degree wanted pregnancies conceived by women with rising mean maternal age, decreasing mean fertility, and ever greater desire and intention to assure a good pregnancy outcome. Available data suggest that about two-thirds of human ova, embryos, and fetuses fail to reach birth or the end of the first year of life, with infant mortality of 1.06%, stillbirth rate of 8/1,000, abortion rate of about 15%, and death rate around the time of implantation estimated at 34%. Based on limited data on sperm, ova aspirated from Graafian follicles in infertile women, direct observation of a few implanting ova, the low rate of human fecundity, and the high failure rate of in vitro fertilization, it seems reasonable to suppose that about 30% of human ova perish at the time of fertilization and before implantation. Most of this prenatal death is attributable to chromosome abnormalities (aneuploidy and polyploidy), estimated to be present at the beginning of development in about half of all human ova or embryos. Parent's anguish about prenatal death and their desire to understand its causes and to prevent recurrence is putting the medical profession under severe pressure to provide diagnostic and counseling services and make available prenatal diagnosis and preventive approaches; this comes at a low point in the ability of Western medicine to respond adequately, especially in the fields of embryology and developmental genetics, clinical teratology, anatomical pathology, and genetic pathology. Unless drastic ameliorative measures are taken, the situation is likely to get much worse, since health insurance pays for only a minute fraction of costs involved and the number of pediatric pathologists devoting major effort to this work in North America has dwindled to a small number without great hope for replacement from younger ranks, primarily as a result of the lack of incentive by the tertiary centers to make fetal genetic pathology ("morphology") an attractive field to work in. Here we report an effort by a secondary care center to provide such a service--presently more on demand than as systematic effort to reach all at need--in a huge, underpopulated state with birthrate of less than 13,000 and lacking any specially trained pathologist with a strong interest in the field.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

Growth of the bronchial tree in man.

Bronchial tree casts were made from one or both lungs from nine children aged from five weeks to 17 years. The branches of the casts were ordered by the method of Strahler, and diameter ratio, length ratio, and branching ratio were determined. From five to 12 weeks the diameter ratio is about 1.35, but by 13 months it has risen to 1.45, indicating a faster rate of growth in the larger airways over the period; thereafter it stays at or above this level. The data show that the peripheral conducting airways are relatively large in diameter at 1-3 months, attaining their adult proportion after one year. In contrast, length ratio shows no trend with age. On the assumption of 25,000 terminal bronchioles, the mean number of orders between terminal bronchiole and trachea was estimated to be about 12.

Adolescent↗
PubMed1987

Flow across the canine ileocolonic junction: role of the ileocolonic sphincter.

The role of the canine ileocolonic sphincter (ICS) in influencing transit of fluids and absorption of water in the ileum was assessed in loops with or without the ICS. Two sets of four dogs each were equipped with isolated ileal loops 40 cm long, attached to the intact bowel through a neuromuscular bridge. In one set, the loop included the ICS and it terminated in an end colostomy; in the other, the loop ended immediately proximal to the ICS, as an ileostomy. Electrical and mechanical signals were recorded from serosal electrodes and strain gauges, respectively, during perfusion of loops with an isotonic solution at rates from 0.7 to 10.0 ml/min. Loops without an ICS propelled fluid by steady, continuous flow at all rates of perfusion; loops with the ICS in place moved fluids in this way only at 10 ml/min. At greater rates of perfusion, fasting cycles of motility were inhibited in all loops and a random pattern of motility developed; this presumably facilitated more steady flow of fluids. At the slowest rate of perfusion, transit times were longer when the ICS was present, but at faster rates both loops showed similar transit times. Presence of the ICS was associated with increased volumes of fluid in the loop and increased absorption of water, especially when loops were perfused slowly. The canine ICS influences flow of saline and absorption in the terminal ileum, but only when flow rates are low.

Animals↗
PubMed1987

Increasing appointment compliance through telephone reminders: does it ring true?

This study evaluated the effectiveness of telephone reminders on appointment-keeping in young people treated for gonorrhea. Compliance with scheduled follow-up was recorded for a total of 339 patients during three two-week periods, namely, initial baseline phase, intervention phase during which attempts were made to remind the patients by telephone, and repeat baseline phase. There was no overall improvement in compliance with follow-up during intervention (31%), compared to baseline (32%). However, data from the intervention phase revealed a significantly higher rate of appointment-keeping for those patients who were contacted (44%) than for patients who were not reachable (20%). Furthermore, when we reanalyzed the data as a function of telephone ownership for all patients who did not receive a reminder, return rates were significantly higher for patients owning telephones (32%) than for those denying phone ownership (18%). Thus, we conclude that the likelihood for appointment compliance was related more to sociobehavioral factors reflected in telephone ownership than to the telephone reminders.

Adolescent↗
PubMed1986

Diameters of arteries, veins, and airways in isolated dog lung.

Triple resin casts were made of the pulmonary arteries, veins, and airways from six dog lungs. The airways were cast at a pressure of 25 cm resin in all six. In the first three, both vessels were cast at a pressure of 30 cm resin, and in the second three, arteries were at 10 cm resin and veins at 5 cm resin. Measurements were made of luminal airway diameters down to 1 mm and of the luminal diameters of the corresponding segments of the vascular trees. The relation of one to the other was shown by calculating the regression lines for the corresponding diameters. Intrapulmonary arteries and veins are of approximately equal diameter when cast at 30 cm resin, while the veins are 20% larger than the arteries when cast at 5 cm and 10 cm of resin, respectively. Both vessel diameters are 75% of bronchial at the higher pressure, while at the lower pressures arteries are 59%, and veins 71% of bronchial. In any individual, vessel diameters are a relatively constant proportion of airway diameter. This constant of proportionality varies considerably between dogs, its value ranging from 0.48 to 1.03. It is concluded that in any individual all three trees have similar diameter ratios--that is, the ratio between mean diameters of branches in successive orders.

Animals↗
PubMed1986

Microinjection of dopamine agonists into nucleus raphe magnus affects nociception in rats.

Microinjection of the dopamine receptor agonist apomorphine, and to a lesser extent dopamine itself, into the nucleus raphe magnus increased tail flick latency in conscious rats. The hypoalgesia was dependent on the integrity of catecholamine-containing pathways originating near the third ventricle and was diminished by systemic depletion of hydroxytryptamine. No simple neuronal circuitry could explain all the effects observed.

5,6-Dihydroxytryptamine↗
PubMed1986

Teenagers' choices regarding the presence of family members during the examination of genitalia.

This study was designed to assess the outcome of offering teenagers the option of being accompanied by a family member during examinations involving the genitalia. Data were collected from patients' first visits, in an 18-month-period, to an adolescent clinic serving a Black, inner-city population. Of 1358 such patients visits (73% females), 550 (40.5%) patients were accompanied to the clinic by a family member. Chi-square analysis revealed: 1) for both sexes, the youngest teenagers (age 11-13 years) were accompanied significantly more often than those aged 14-16 years, who in turn were accompanied significantly more often than the oldest group (age 17-20 years); and 2) although males tended to be accompanied more often than females, this effect was significant only for teenagers aged 14-16 years. Of the 550 accompanied patients, 207 had a genital examination and 190 of these were offered the option of having a family member present. Fifty percent of the patients accepted; there was no significant relationship between patients' age or sex and acceptance. Physicians judged the outcome of the 94 cases with family member present. Having the family member present was viewed as beneficial for the patient and/or the physician in 86% of the cases, and 13% were neutral (no benefit/no problem).

Adolescent↗