Biomedical subjects

Michael Phillips

Publications and source records attributed to Michael Phillips.

40 records · Page 3Linked to original sources

PubMed2002

Investigation of bioterrorism-related anthrax, United States, 2001: epidemiologic findings.

In October 2001, the first inhalational anthrax case in the United States since 1976 was identified in a media company worker in Florida. A national investigation was initiated to identify additional cases and determine possible exposures to Bacillus anthracis. Surveillance was enhanced through health-care facilities, laboratories, and other means to identify cases, which were defined as clinically compatible illness with laboratory-confirmed B. anthracis infection. From October 4 to November 20, 2001, 22 cases of anthrax (11 inhalational, 11 cutaneous) were identified; 5 of the inhalational cases were fatal. Twenty (91%) case-patients were either mail handlers or were exposed to worksites where contaminated mail was processed or received. B. anthracis isolates from four powder-containing envelopes, 17 specimens from patients, and 106 environmental samples were indistinguishable by molecular subtyping. Illness and death occurred not only at targeted worksites, but also along the path of mail and in other settings. Continued vigilance for cases is needed among health-care providers and members of the public health and law enforcement communities.

Adult↗

PubMedDate not supplied

Volatile markers of breast cancer in the breath.

Breast cancer is accompanied by increased oxidative stress and induction of polymorphic cytochrome P-450 mixed oxidase enzymes (CYP). Both processes affect the abundance of volatile organic compounds (VOCs) in the breath because oxidative stress causes lipid peroxidation of polyunsaturated fatty acids in membranes, producing alkanes and methylalkanes which are catabolized by CYP. We performed a pilot study of breath VOCs, a potential new marker of disease in women with breast cancer. This was a combined case-control and cross-sectional study of women with abnormal mammograms scheduled for a breast biopsy. Breath samples were analyzed by gas chromatography and mass spectroscopy in order to determine the breath methylated alkane contour (BMAC), a three-dimensional display of the alveolar gradients (abundance in breath minus abundance in room air) of C4-C20 alkanes and monomethylated alkanes. BMACs in women with and without breast cancer were compared using forward stepwise discriminant analysis. Two hundred one breath samples were obtained from women with abnormal mammograms and biopsies read by two pathologists. There were 51 cases of breast cancer in 198 concordant biopsies. The breath test distinguished between women with breast cancer and healthy volunteers with a sensitivity of 94.1% (48/51) and a specificity of 73.8% (31/42) (cross-validated sensitivity 88.2% (45/51), specificity 73.8% (31/42)). Compared to women with abnormal mammograms and no cancer on biopsy, the breath test identified breast cancer with a sensitivity of 62.7% (32/51) and a specificity of 84.0% (42/50) (cross-validated sensitivity of 60.8% (31/51), specificity of 82.0% (41/50)). The negative predictive value (NPV) of a screening breath test for breast cancer was superior to a screening mammogram (99.93% versus 99.89%); the positive predictive value (PPV) of a screening mammogram was superior to a screening breath test (4.63% versus 1.29%). A breath test for markers of oxidative stress accurately identified women with breast cancer, with an NPV superior to a screening mammogram. This breath test could potentially be employed as a primary screen for breast cancer. Confirmatory studies in larger groups are required.

Aged↗

PubMedDate not supplied

Diet, activity, and other lifestyle risk factors for forearm fracture in postmenopausal women in China: a case-control study.

OBJECTIVE: Forearm fractures are a major cause of disability in postmenopausal women, but the risk factors have not been previously studied in China and the results from Western studies may not be applicable to the Chinese population. The aim of this study was to determine whether calcium intake, activity level, lifestyle, and other factors are associated with risk of forearm fracture among Chinese postmenopausal women. DESIGN: In this case-control study, the authors used a structured questionnaire to assess potential risk factors in 209 postmenopausal women 50 to 70 years old with new forearm fractures identified in eight hospitals in Chengdu and in age and location of residence-matched control subjects randomly selected from the community. RESULTS: Adjusted odds ratios (95% CIs) were as follows: each quintile increase in current energy intake 0.46 (0.36, 0.60); fifth quintile energy-adjusted current calcium intake versus lowest quintile, 0.17 (0.06, 0.47); eating bean products when 30 to 49 years old, 0.15 (0.05, 0.47); eating meat, 0.13 (0.02, 0.74) and eating pork ribs, 0.37 (0.17, 0.83) when 16 to 29 years old; greater past activity, 0.78 (0.68, 0.89) and present activity, 0.84 (0.74-0.96); greater height (per centimeter), 1.12 (1.06, 1.20); each year irregular menses before menopause, 1.25 (1.04, 1.49); each floor of residence, 1.71 (1.38, 2.12); and prior fracture in first- or second-degree relatives, 2.74 (1.08, 6.92). CONCLUSION: Some risk factors for forearm fractures were similar to those described in white women, whereas others were specific to this ethnic setting, and would need to be considered in future preventive programs.

Aged↗

PubMedDate not supplied

Breath markers of oxidative stress in patients with unstable angina.

Cardiac chest pain is accompanied by oxidative stress, which generates alkanes and other volatile organic compounds (VOCs). These VOCs are excreted in the breath and could potentially provide a rational diagnostic marker of disease. The breath methylated alkane contour (BMAC), a 3-dimensional surface plot of C4-C20 alkanes and monomethylated alkanes, provides a comprehensive set of markers of oxidative stress. In this pilot study, we compared BMACs in patients with unstable angina pectoris and in healthy volunteers. Breath VOCs were analyzed in 30 patients with unstable angina confirmed by coronary angiography and in 38 age-matched healthy volunteers with no known history of heart disease (mean age +/- SD, 62.7 +/- 12.3 years and 62.5 +/- 10.0, not significant). BMACs in both groups were compared to identify the combination of VOCs that provided the best discrimination between the 2 groups. Forward stepwise entry discriminant analysis selected 8 VOCs to construct a predictive model that correctly classified unstable angina patients with sensitivity of 90% (27 of 30) and specificity of 73.7% (28 of 38). On cross-validation, sensitivity was 83.3% (25 of 30) and specificity was 71.1% (27 of 38). We conclude that the breath test distinguished between patients with unstable angina and healthy control subjects.

Alkanes↗