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L Moon

Publications and source records attributed to L Moon.

10 recordsLinked to original sources

Diagnostic accuracy of fracture detection in suspected non-accidental injury: the effect of edge enhancement and digital display on observer performance.

AIM: To compare the effect of varying degrees of edge enhancement and method of digital image display on fracture detection in suspected non-accidental injury (NAI). MATERIALS AND METHODS: Fifty radiographs from post-mortem skeletal surveys in 13 children with suspected NAI were selected. Images were obtained using a Fuji 5000R computed radiography system. Hard copies were printed with edge enhancement factors 0, 0.5 and 1.2. Images (edge enhancement 0.5) were also displayed on a 1K(2) monitor. Six observers independently evaluated all 200 images for the presence of abnormality. Observers also scored each image for visualization of soft tissues, visualization of trabecular markings and overall image quality. The paired Student's t-test and location receiver operating curve (ROC) analysis were used to compare quality scores and diagnostic accuracy of each display method. Individual and pooled true-positive rates (sensitivity) were determined. For the purposes of ROC analysis, histology was taken as the gold standard. RESULTS: There was no difference in duration of hard and soft-copy reading sessions (p=0.76). After image manipulation soft-copy radiographs scored significantly better for image quality than hard copy (p<0.0001). Pooled observer sensitivity (at a specificity of 90%) was below 50% for all display methods. Diagnostic accuracy varied significantly between observers. Diagnostic accuracy of individual observers was not affected by display method. CONCLUSION: In suspected NAI, diagnostic accuracy of fracture detection is generally low. Diagnostic accuracy appears to be affected more by observer-related factors than by the method of digital image display.

Child Abuse↗

Advances in paediatric tumour imaging.

There have been a number of major advances in imaging technology in recent years. Here we discuss in detail multislice CT and PET, since these are the two modalities generating the most interest in cancer imaging, but which also have the potential for significantly increasing the radiation burden in the paediatric population. In addition, we focus on the implications of the new Response Evaluation Criteria In Solid Tumours (RECIST) guidelines, which describe a significant new method of tumour size measurement.

Child↗

Immunogenicity of single-dose diphtheria vaccines based on PLA/PLGA microspheres in guinea pigs.

Biodegradable polyester microspheres (MS) have shown potential for single-dose vaccines. This study examined the immunogenicity of diphtheria toxoid (Dtxd) microencapsulated in different types of poly(lactide) (PLA) and poly(lactide-co-glycolide) (PLGA) MS prepared by the methods of spray-drying and coacervation. We investigated the influence of polymer type (PLGA 50:50 of low M(w); PLA of high M(w); end-group stearylated PLAs of low M(w)) and co-encapsulated excipients (BSA and/or trehalose) on Dtxd content, in vitro release and immunogenicity in guinea pigs. The co-encapsulated trehalose lowered the Dtxd entrapment efficiency in the spray-dried particles from 75 to 56%, whereas albumin alone had no effect in the spray-drying, but improved the encapsulation in the coacervation process. With the hydrophobic, end-group stearylated PLAs, Dtxd could only be encapsulated in the presence of albumin. Guinea pigs immunised with Dtxd-MS made with the relatively hydrophilic PLGA 50:50 exhibited specific and sustained antibody responses over 40 weeks, comparable to the responses to alum-adjuvanted toxoid. In contrast, undetectable or very low antibody responses were determined after immunisation with MS made with hydrophobic polymers. Surprisingly, large (15-60 microm) and small (1-5 microm) MS gave comparable primary antibody responses. In conclusion, the data presented confirm the feasibility of MS vaccines to induce strong, long-lasting protective antibody responses after a single immunisation.

Animals↗

The health of Australian children and young adults: recent statistics.

The lack of reliable national statistics to monitor the health of Australian children and youths is well recognised (Commonwealth Department of Human Services and Health 1995). There is a clear need to develop this information through a nationally integrated and coordinated approach. The best way to achieve this would be to scope the fields of child and youth health information, identify data gaps and deficiencies, and catalogue the data requirements and needs. The framework within which this should occur, accompanied by a national child and youth health information development plan, also needs to be clearly defined. The Australian Institute of Health and Welfare is undertaking an analysis of the health of Australian children and youths and a review of available information in this area. Here we present early work on this project, providing a general picture of the health of Australian children and youths based on mortality, morbidity, reported health status and disability statistics. Some information on the health of indigenous children and young people is also included.

Adolescent↗

Bench evaluation: three face-shield CPR barrier devices.

UNLABELLED: Due to the fear of disease transmission, the practice of mouth-to-mouth (M-M) rescue breathing is rarely performed; to address this concern, many types of CPR barrier devices have been developed. These include bag-valve-mask devices, mouth-to-mask devices, and face shields (FS). The purpose of this study was to measure the volumes delivered during mouth-to-face shield (M-FS) breathing, to measure the back pressure and calculate the resistance to flow through their 1-way valves, and to test for backward leak of gas through the valves. METHODS: Three FS brands were evaluated: Kiss of Life (KOL), MicroSHIELD (Micro) and Res-Cue Key (RCK). Volume delivered during M-M and M-FS breathing was evaluated by 10 rescuers who used the devices while performing rescue breathing on a CPR mannequin. Back pressure was measured and resistance calculated by directing airflow through the 1-way valves. Backward leak was evaluated by measuring the O2 concentration at the rescuer side of the valve while 100% O2 was directed toward the patient side of the valve. Differences among the brands were evaluated using analysis of variance. RESULTS: The mean (SD) values for volumes in L were: M-M 1.00 (0.25), Micro 0.77 (0.20), RCK 0.64 (0.10), and KOL 0.24 (0.11). Mean values for back pressure in cm H2O at 50 L/min were Micro 16.7 (1.29), KOL 7.22 (0.13), and RCK 2.15 (0.16). Significant backward leak only occurred with RCK. CONCLUSION: Not one of the FSs tested met all of the requirements suggested by the American Heart Association and by the International Standards Organization.

Analysis of Variance↗

Hytrin treatment of hypertension and benign prostatic hyperplasia.

BPH is a diagnosis that needs to be considered and evaluated in older male renal disease/failure patients. Rather than proceeding to the invasive treatment options, Hytrin should be considered as the treatment of choice. Not only can it relieve the symptoms of BPH, but also be an effective treatment for hypertension. Ongoing assessment, observation for side effects, monitoring for lower urinary tract dysfunction, along with patient education and documentation are the responsibilities of nephrology nurses.

Adrenergic alpha-Antagonists↗

Transport of antibiotics into the canine sinus. Experiments with penicillin G and erythromycin.

Complete and consistent occlusion of the nasofrontal duct of the canine sinus was achieved by introducing acrylic through a trephinated opening in the nasal dorsum. This surgical procedure resulted in the isolation of the frontal sinus, without impairing the integrity of the cavity. In this experimental canine model, potassium penicillin G and erythromycin lactobionate were absorbed into the blood equally well when placement was either in the intramuscular (IM) space or in frontal sinus cavity. When different concentrations of these antibiotics were injected into the IM space, peak blood levels occurred between one and two hours; however, peak sinus levels, following IM introduction, did not occur until four hours. The peak ratios show that between 4% and 20% of penicillin, and 1% and 12% of erythromycin in the blood is transferred across the normal sinus membrane.

Absorption↗

Damaging drugs.

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Anticonvulsants↗