Biomedical subjects

Julie A Phillips

Publications and source records attributed to Julie A Phillips.

4 recordsLinked to original sources

PubMed2006

Drifting blooms of the endemic filamentous brown alga Hincksia sordida at Noosa on the subtropical east Australian coast.

Since 2002, the usually uncommon endemic filamentous brown alga Hincksia sordida (Harvey) Silva (Ectocarpales, Phaeophyta) has formed nuisance blooms annually during spring/early summer at Main Beach, Noosa on the subtropical east Australian coast. The Hincksia bloom coincides with the normally intensive recreational use of the popular bathing beach by the local population and tourists. The alga forms dense accumulations in the surf zone at Main Beach, giving the seawater a distinct brown coloration and deterring swimmers from entering the water. Decomposing algae stranded by receding tides emit a nauseating sulphurous stench which hangs over the beach. The stranded algal biomass is removed from the beach by bulldozers. During blooms, the usually crowded Main Beach is deserted, bathers preferring to use the many unaffected beaches on the Sunshine Coast to the south of Main Beach. The bloom worsens with north-easterly winds and is cleared from Noosa by south easterly winds, observations which have prompted the untenable proposal by local authorities that the bloom is forming offshore of Fraser Island in the South Pacific Ocean. The Noosa River estuarine system/Laguna Bay is the more probable source of the bloom and the nutrient inputs into this system must be substantial to generate the high bloom biomass. Current mitigation procedures of removing the blooming alga off the beach with bulldozers treat the symptom, not the cause and are proving ineffective. Environmental management must be based on science and the Noosa bloom would benefit greatly from the accurate ecological data on which to base management options.

Australia↗

PubMed2006

Glomeruloid hemangioma leading to a diagnosis of POEMS syndrome.

POEMS is an acronym for polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes. It is a poorly understood paraneoplastic syndrome that stems from an underlying plasma cell dyscrasia. Of the skin changes, the glomeruloid hemangioma is considered to be a specific marker of POEMS syndrome. We describe a 68-year-old man who presented to his dermatologist with multiple hemangiomas, whose biopsy diagnosis of glomeruloid hemangioma resulted in further evaluation and an eventual diagnosis of POEMS.

Aged↗

PubMed2004

Context or composition: what explains variation in SCHIP disenrollment?

OBJECTIVE: To investigate (1) the relative contributions of family and contextual characteristics to observed variation in disenrollment rates from the State Children's Health Insurance Program (SCHIP), and (2) whether context explains observed family-level patterns. DATA SOURCES: We use secondary data on 24,628 families enrolled in New Jersey's SCHIP program (NJ KidCare), and county-level data from the Area Resource File, the Census, and the NJ FamilyCare provider roster. STUDY DESIGN: Information on family characteristics, SCHIP plan, and dates of enrollment and disenrollment are taken from NJ KidCare administrative records, which provided surveillance data from January 1998 through April 2000. DATA COLLECTION/ANALYSIS: We estimate a multilevel discrete-time-hazards model of SCHIP disenrollment. FINDINGS: Families enrolled in plans involving cost-sharing, blacks, and those with only one enrolled child have higher than average rates of disenrollment. Disenrollment rates for blacks are lower in counties with a high share of black physicians. These characteristics account for part of the intercounty variation in disenrollment rates; remaining intercounty variation is largely explained by physician density or population density. POLICY IMPLICATIONS: It may be worthwhile to pay special attention to black families and counties with high disenrollment rates to address the reasons for their lower retention. Addressing cultural differences between physician and client and the geographic distribution of medical providers might reduce disenrollment.

Child↗

PubMed2003

Bacterial colonization of the donor lower airways is a predictor of poor outcome in lung transplantation.

OBJECTIVE: At the time of lung transplant, we routinely perform bronchoalveolar lavage (BAL) of the donor lungs on the recipient operating table immediately before implantation, for bacterial and fungal cultures. We sought to determine whether the results correlate with the outcome. METHODS: We retrospectively analysed 115 consecutive cadaveric lung transplants (single lung: 42; bilateral lung: 63; heart-lung: 10) performed over 4 years. RESULTS: Fifty-three (46%) grafts had positive BAL (bacteria: 33; fungus: 10; mixed: 10) and 62 (54%) were negative. Recipients with donor BAL culture positive for bacteria had lower mean oxygenation index in the first 6 h compared with those with negative bacterial culture (36.5+/-14.73 vs. 44.1+/-16.79 kPa) (P=0.019). They also had longer median intensive treatment unit stay (2.5 vs. 1.5 days) (P=0.035), and median time of mechanical ventilation (37.5 vs. 23.0 h) (P=0.008), as well as inferior 6-month, 1-year, 2-year and 4-year cumulative survival (79, 77, 74, 60% vs. 93, 92, 88, 79% respectively) (P=0.04). There was no difference in the above parameters between recipients with Gram-negative (n=18) and recipients with Gram-positive bacteria (n=19) in the donor BAL. Incidence of acute rejection within the first 2 weeks and time of onset of bronchiolitis obliterans syndrome (BOS) were similar in the bacteria-positive and bacteria-negative groups. Recipients with donor BAL positive for fungi alone had similar outcome with the negatives. There was no difference in the donor oxygenation index and age, recipient age, transplant type and ischaemic time between compared groups. There was a significant difference in the median length of donor mechanical ventilation between donors with Gram-positive and donors with Gram-negative bacteria in the BAL (24 vs. 48 h) (P=0.01), as well as between donors with fungi alone in the BAL and donors with negative BAL (67 vs. 48 h) (P=0.04). CONCLUSIONS: Donor lungs with lower airways colonized with bacteria result in inferior recipient outcome. Bacterial colonization of the donor lower airways could therefore be used as a marker of donor lung injury, but evidence from a prospective study is necessary.

Adolescent↗