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Biomedical subjects

D J Manning

Publications and source records attributed to D J Manning.

18 recordsLinked to original sources
PubMed2004

Detection or decision errors? Missed lung cancer from the posteroanterior chest radiograph.

A test bank of verified chest radiographs was compiled for visual search experiments to investigate radiology performance in the detection of early lung cancer. A measure of the physical characteristics of the lesions was derived to determine the conspicuity (chi) of the nodules and to investigate possible causes of failed detection. Observer performance was measured by alternate free response operating characteristic (AFROC) methodology and was supplemented with visual search recording. Correlation of AFROC scores and the chi values was poor but inspection of the visual search recordings showed that most nodules were fixated. Fixations on missed lesions produced average dwell times greater than three times the minimum duration thought to be associated with detection. We conclude that the majority of errors were failures of decision rather than detection and comment on the implications of this for strategies to improve diagnostic effectiveness.

Clinical Competence↗
PubMed2002

Perceptual and signal detection factors in radiography.

Diagnostic imaging systems (e.g. X-rays and ultrasound) play an important role in medicine. Owing to increasing workloads now carried by clinical radiologists, the interpretation of medical images is increasingly being passed to radiographers. This is especially so in those areas of diagnoses where examinations are performed on large numbers of patients but when the frequency of the disorder is very low (e.g. mass mammography screening). This study explored the accuracy of the radiographic interpretation of pulmonary nodules by clinical radiologists and student radiographers, and their correlations with tests of field-dependency, visual search and spatial reasoning. Overall performance in lung nodule detection gave a mean ROC (Az)=0.851 for student radiographers, while radiologists achieved 0.871. No correlation was found between diagnostic performance and either fielddependency or visual search. A significant negative correlation was found between diagnostic performance and spatial reasoning (p < 0.05).

Adult↗
PubMed2000

Presumed consent in emergency neonatal research.

Current methods of obtaining consent for emergency neonatal research are flawed. They risk aggravating the distress of parents of preterm and other sick neonates. This distress, and the inevitable time constraints, compromise understanding and voluntariness, essential components of adequately informed consent. Current practice may be unjust in over-representing babies of more vulnerable and deprived parents. The research findings may thus not be generalisable. Informing parents antenatally about the possible need for emergency neonatal research, with presumed consent and scope for opting out, would address these problems. It would spare parents of sick neonates, already terrified by their baby's illness, further distress. Experience with opting out suggests that recruitment might increase, thus generating earlier results, without compromising parental understanding of the nature and purpose of the research.

Clinical Trials as Topic↗
PubMed1991

Haem arginate in acute hereditary coproporphyria.

An 11 year old boy presented with severe acute hereditary coproporphyria. Despite supportive measures his condition deteriorated after admission. Haem arginate, started two days after presentation, produced appreciable inhibition of porphyrin precursor overproduction and clinical improvement.

Arginine↗
PubMed1988

Oesophageal motor activity and sleep state in the newborn human infant.

Oesophageal pressure and ventilation were recorded during sleep in healthy full-term neonates with sleep state defined by one of two methods; in 35 infants by combined behavioural and electroencephalographic criteria, and in a further 13 infants by behavioural criteria alone. Spontaneous oesophageal contractions occurred in all infants during active sleep but rarely during quiet sleep. The transition from active to quiet sleep was accompanied by a gradual reduction in the frequency of these contractions. Oesophageal contractions associated with sighs and contractions shortly following interruption of breathing suggestive of swallowing were also significantly more common in active sleep. In 13 infants who showed periodic breathing the same differences in prevalence of spontaneous oesophageal contractions in each sleep state were observed.

Esophagus↗
PubMed1987

Non-convulsive status epilepticus.

Status epilepticus can complicate any type of seizure activity. A group of 13 children with non-convulsive status has been studied. Five presented with chronic fluctuating neurological features, while eight had intermittent episodes of their atypical status, although each of these lasted for several days. The clinical features, treatment, and outcome for these groups of children are described. Most of the children in both groups are mentally retarded after regressing at the time of their status epilepticus. The recognition and aggressive treatment of atypical status is important in reducing the risk of subsequent mental handicap.

Anticonvulsants↗
PubMed1985

Candida in mouth or on dummy?

Mouth and dummy swabs for Candida spp. were obtained from 100 children under 18 months old admitted with acute medical conditions. Forty four per cent of dummies were colonised by Candida spp. Children who sucked dummies had clinical thrush and positive mouth swabs for candida more frequently than those who did not.

Candida↗
PubMed1976

Heterotopic urinary bladder with a communicating reservoir.

A heterotopic bladder attached to an Ommaya reservoir was transplanted to the back of a syngeneic rat. Following transplantation, the mucosa underwent ischemic necrosis. However, it was rapidly reepithelialized in 2 weeks as a result of spreading of the epithelium originating from the ureterotrigonal region. By light microscopy the regenerated epithelium was indistinguishable from the normal transitional epithelium, and the cannula connecting the reservoir to the bladder remained patent throughout the observation period of 22 weeks. One bladder, when examined at 22 weeks, contained a transitional cell papilloma with squamous metaplasia. Although further study is needed, this model is potentially useful in studies related to bladder carcinogenesis.

2-Acetylaminofluorene↗
PubMedDate not supplied

Sleep state, hypoxia and periodic breathing in the neonate.

The influence of sleep state on hypoxia-induced periodic breathing was evaluated in full-term babies studied during the first week of life. Following exposure to 15% O2, periodic breathing occurred in 7 of 42 babies during quiet sleep, and 5 of 20 during active sleep (p less than 0.05). The median levels of transcutaneous pO2 at which periodic breathing occurred during hypoxia, and was abolished on reoxygenation were similar in each sleep state. The median duration of periodic apnoea was significantly greater in quiet than active sleep. In 7 babies the occurrence of periodic breathing during hypoxia was accompanied by a change in sleep state. This was probably coincidental in 3 cases, but in the other 4 babies hypoxia may have induced both the change in state and breathing pattern.

Apnea↗