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Biomedical subjects

R B Phillips

Publications and source records attributed to R B Phillips.

At least 19 recordsLinked to original sources
PubMed1992

Evolutionary relationships of the salmonid fish genus Salvelinus inferred from DNA sequences of the first internal transcribed spacer (ITS 1) of ribosomal DNA.

DNA sequences of the ribosomal DNA (rDNA) first internal transcribed spacer region (ITS 1) of six species of the salmonid fish genus Salvelinus (alpinus, malma, confluentus, leucomaenis, fontinalis, and namaycush) and the closely related species Hucho perryi were determined. Phylogenetic analysis of the aligned sequences by both phenetic and cladistic methods with H. perryi as an outgroup generated one best topology which pairs S. alpinus with S. malma as the most recently derived species, and pairs S. confluentus with S. leucomaenis. Three other possible topologies favor the pairing of S. namaycush and S. fontinalis, with one tree placing them on separate branches, and vary the branching order of the interior groups. These results agree with previous studies based on comparisons of morphologies, isozymes, karyotypes, and restriction sites showing a close genetic relationship and possible hybridization between the members of this genus.

Animals↗
PubMed1992

The descriptive profile of low back pain patients of field practicing chiropractors contrasted with those treated in the clinics of west coast chiropractic colleges.

OBJECTIVE: To compare the demographic and clinical characteristics of low back pain patients from chiropractic college clinics and private practice settings on the west coast of the United States. DESIGN AND SETTING: A survey analysis of consecutive new patients in a specified time frame from multiple private office settings contrasted with a previous survey of consecutive new patients in a similar time frame from chiropractic college clinics. PATIENTS: In the private practice setting, new patients were selected on a consecutive basis as subjects for the study. Selection was limited to low back pain patients. INTERVENTIONS: None. This was a self-report survey only. MAIN OUTCOME: There is a strong similarity of the two low back pain patient groups, with the exception of higher levels of income, work time loss, severity and functional disability reported in the private practice setting. RESULTS: Similarities between the two low back pain patient groups were found in the distribution of gender, age, job description and education. Statistical significances were not determined due to variations in data collection. CONCLUSIONS: The two patient populations are reasonably comparable in sociodemographic variables, but clinical variation does exist. These results suggest the need to consider clinical findings when extrapolating research findings in a college clinic setting to the chiropractic profession in general.

Adult↗
PubMed1992

Proposal for establishing structure and process in the development of implicit chiropractic standards of care and practice guidelines.

With the advent of health care's "era of accountability", the chiropractic profession is now faced with generating implicit standards and guidelines for care or having it done for us by outside agencies. Already we see chiropractic groups in individual states and provinces being pressured into naive efforts of guideline development. Current knowledge and experience are available through recent health care literature that clearly defines the structure and process of guideline development and offers suggestions on how to measure outcomes of those processes. In addition, the United States Congress has directed a new federal agency to oversee this activity and monitor outcomes of quality improvement programs. The time has come for the chiropractic profession to define its exact role in health care delivery and develop implicit standards of care and practice guidelines. This sentinel effort should be managed by a commissioned body of empaneled experts that generally represent the academic and clinical chiropractic profession. A protocol for selection of these panelists and the panel chairperson needs to be developed and memorialized. Appropriate methodology (with definitions) needs to be developed for the process of standards/guideline development. Adherence to the accepted structure and process of guideline development will ensure the continuity of this dynamic process in the coming generations. This proposal offers a preliminary definition of the structure and process, including a "seed" policy statement and decision flow chart, specific to guideline development. Once the structure and process of guideline development for chiropractic are defined, the profession can then present this product to federal and state agencies, private sector health care purchasers, patient advocacy groups and other stakeholders of chiropractic care.(ABSTRACT TRUNCATED AT 250 WORDS)

Chiropractic↗
PubMed1992

Functional outcomes of low back pain: comparison of four treatment groups in a randomized controlled trial.

The revised Oswestry Low Back Pain Questionnaire (ROLBPQ) and Roland-Morris Activity Scale (RMAS) were compared in a randomized controlled trial of chiropractic manipulation, stroking massage, corset and transcutaneous muscular stimulation (TMS). This trial employed specific inclusion and exclusion criteria, including nonspecific low back pain for a duration of 3 wk to 6 months and ages between 18 and 55. We had the opportunity to ask 85 patients to answer the questionnaires. Sixty-three patients, who completed the initial and final evaluations, were used for data analysis. Both ROLBPQ and RMAS showed good internal consistency with alpha coefficients ranging from .77 to .93. Both instruments showed a significant difference between the chiropractic manipulation and massage groups (p less than .05). RMAS was able to further show significant differences between the chiropractic manipulation and TMS groups, and between the corset and massage groups, but the ROLBPQ failed to do so. RMAS also showed that chiropractic manipulation had a better but nonsignificant result than corset, possibly due to insufficient sample size and/or duration of treatment. We conclude that both instruments are reliable for measuring low back pain disability, and chiropractic manipulation has a superior short-term benefit when compared to stroking massage and TMS in subacute low back pain patients. In addition, it appears that RMAS is preferable in a clinical trial situation for subacute low back pain because it is more sensitive than ROLBPQ to detect changes.

Adolescent↗
PubMed1992

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↗
PubMed1991

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↗
PubMed1991

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↗
PubMed1990

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↗
PubMed1989

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↗
PubMed1989

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↗
PubMed1988

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↗
PubMed1986

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↗
PubMed1986

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↗
PubMed1986

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↗
PubMed1985

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↗
PubMed1985

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↗