Search PubMed⌕ Search

Biomedical subjects

L Moore

Publications and source records attributed to L Moore.

At least 55 records · Page 3Linked to original sources
PubMed1996

Case for active physician involvement in US practice.

PURPOSE: To assess the benefit of active physician involvement in ultrasound (US) examinations. MATERIALS AND METHODS: Concordance of findings by technologists and physicians was assessed prospectively for examinations of 1,510 consecutive patients who underwent US during regular working hours. RESULTS: Overall concordance was generally good (74%). However, in cases in which a major or minor new diagnosis was made from the US scan, concordance rates were substantially lower (36% and 32%, respectively). Agreement varied with the type of examination. The discordance rate for obstetric examinations (17%) was only half that for abdominal and pelvic examinations (31%). Concordance improved with increasing years of experience of the technologist. CONCLUSION: An active role of physicians in the overall conduct of US examinations is essential to optimize provision of a complete, accurate report.

Diagnostic Errors↗
PubMed1996

Rapid placement of transpyloric feeding tubes: a comparison of pH-assisted and standard insertion techniques in children.

OBJECTIVE: To compare transpyloric feeding tube placement using a pH-assisted placement technique versus a standard placement technique in pediatric patients requiring enteral nutrition. METHODS: Critically ill children younger than 4 years were prospectively and randomly assigned to either a pH-assisted or a standard feeding tube placement group. Identical pH-assisted feeding tubes were used in both groups; however, feeding tubes in the standard group were not attached to a portable pH meter. Successful transpyloric placement was confirmed by radiography before beginning feedings. If placement was not successful, a second placement attempt was made after metoclopramide administration. Information regarding tube placement success, number of radiographs, time to initiation of feedings, and daily caloric intake was collected. A cost comparison between the two groups was performed. RESULTS: Thirty-four patients were enrolled in the pH-assisted group, and 34 were enrolled in the standard feeding tube group. Ninety-seven percent of patients in the pH-assisted group had successful placement after the first attempt, compared with 53% of patients in the standard group. The average time to successful placement of pH-assisted feeding tubes was 6 minutes. All patients in the pH-assisted group had successful placement after the second attempt, compared with 78% of patients in the standard group. A pH of greater than 5.6 accurately predicted transpyloric placement in 97% (33 of 34) of individuals in the pH-assisted group. Children in the pH-assisted group required significantly fewer radiographs than those in the standard group. Hospital costs were $114 per patient in the pH-assisted group and $135 per patient in the standard group. CONCLUSIONS: Our findings indicate that bedside transpyloric placement of pH-assisted feeding tubes can be accomplished rapidly and with a high success rate. This method is associated with decreased radiation exposure and economic savings when compared with a standard placement technique.

Child, Preschool↗
PubMed1995

Prenatal diagnosis of Smith-Lemli-Opitz syndrome.

An abnormality in cholesterol synthesis was described recently in the Smith-Lemli-Opitz (SLO) syndrome. Here we describe how the application of this finding has enabled an accurate prenatal diagnosis. We also discuss the possible use of this test in detecting heterozygotes.

Abnormalities, Multiple↗
PubMed1995

Autoimmune enteropathy with anti-goblet cell antibodies.

A 9-year-old boy with a 5-year history of severe protracted diarrhea requiring home parenteral nutrition and a 1 year history of abnormal liver function tests was admitted for duodenal, rectal, and liver biopsy. Duodenal biopsy results showed mild villus blunting, a mild lymphocytic infiltrate, and absent goblet cells. Paneth cells and endocrine cells could not be identified. Review of several previous biopsies showed an almost total absence of goblet cells by light microscopy. Anti-goblet cell antibodies of the immunoglobulin (Ig)G class were shown by immunofluorescence with a titer of 1:512. Histological examination of rectal mucosa also showed a total lack of goblet cells, orderly surface epithelial cells, and infiltration of the colonic crypts by lymphocytes. Immunoperoxidase staining of rectal mucosa showed increased numbers of lymphocytes with an excess of CD3+, CD45RO+ T cells, and increased numbers of B cells labeling with B1 and L26. Increased numbers of CD25+ (activated) lymphocytes were also observed. HLA/DR expression was striking and observed in both the crypt and surface enterocytes, as well as in the lamina propria. Immunological assessment of the patient showed an inverted CD4/CD8 ratio and IgA/IgG4 deficiency. The liver biopsy and radiological investigation were in keeping with chronic sclerosing cholangitis. Although a slight and transient improvement in histological appearances was observed with prednisolone there was no significant improvement of diarrhea. Trials of azothiaprine and oral cyclosporin did not result in clinical or histological improvement.

Autoantibodies↗
PubMed1995

Elevation of breath ethanol measurements by metered-dose inhalers.

STUDY OBJECTIVE: Metered-dose inhalers (MDIs) may contain as much as 38% ethanol. We evaluated the effects of ethanol-containing MDIs on breath alcohol testing. DESIGN: Prospective, single-blind, crossover, controlled study. PARTICIPANTS: Three healthy male volunteers 29 to 36 years old. INTERVENTION: We studied three brands: Tornalate, (38% ethanol), Bronkometer, (30% ethanol), and Alupent, (0% ethanol). The effects of each MDI on breath and blood ethanol measurements were evaluated separately. Two puffs of each brand of MDI were administered. Breath ethanol measurements were obtained at baseline and .25, .5, 1, 2, 3, 5, and 10 minutes after MDI use. Blood ethanol measurements were obtained at baseline and 1 and 10 minutes after MDI use. RESULTS: Overall, Tornalate had the highest breath ethanol readings, with a mean ethanol level of 189 mg/dL recorded just after MDI use. Breath ethanol levels subsequently decreased rapidly over time. Mean breath ethanol concentrations were lower after the use of Bronkometer and undetectable after the use of Alupent. Blood ethanol levels were undetectable at all times tested. CONCLUSION: MDIs may cause elevations of breath alcohol above the legal criteria for intoxication. These effects are transient and may be prevented by a 10-minute interval between the use of an MDI and breath alcohol testing.

Administration, Inhalation↗
PubMed1995

Unexpected infant death in association with suspended rocking cradles.

We report on the deaths of two infants aged 10 1/2 and 11 weeks who were found face down in the angle between the base and side of their frame-suspended rocking cradles. Locking pins designed to prevent tilting of the cradles were not in place in either case. Investigation of the two cradles associated with the infant deaths and six other similar rocking cradles available for purchase in South Australia revealed either marked angles of tilt or inadequate or nonchildproof locking devices in all cases. A study of live control infants placed in similar situations demonstrated support for the possibility of positional asphyxia. We consider that these cases represent another potentially lethal sleeping environment for infants and emphasize the importance of death scene examination in all cases of unexpected infant death.

Accidents, Home↗
PubMed1995

The danger of freely rocking cradles.

OBJECTIVE: To assist the Adelaide State Coroner with his inquest into the death of two infants in South Australia, and to assist the Department of Public and Consumer Affairs develop Australian Standards for rocking cradles. METHODOLOGY: A sample of each brand of new cradle commercially available in South Australia was examined. Videotapes were made of 11 healthy infants in rocking cradles to examine how they moved and how they reacted in different positions. RESULTS: Many cradles had insecure locking pins. Infants in a cradle tilted at 10 degrees greater, face down with the side of the face against the bars, and an aim trapped between the body and bars or through the bars, were unable to obtain a clear airway unless a dummy was in the mouth. CONCLUSIONS: Infants should never be left unattended in freely rocking cradles. Australian Standards should recommend locking pins be bolted into place and that cradles cannot tilt to greater than 5 degrees.

Age Factors↗
PubMed1995

Aboriginal wellbeing and liquor licensing legislation in Western Australia.

This paper is based on the results of a project undertaken as the basis for a submission to the committee established to review the Western Australian Liquor Licensing Act 1988. It reports on key issues relating to liquor licensing, as identified by members of regional Aboriginal organisations. Among these issues are the promotion of alcohol consumption and misuse, discriminatory practices by licensees and the police and the need for greater community involvement in liquor licensing decisions. To address these issues, members of the participating organisations proposed: inclusion of a harm-minimisation objective in the Act, education and training programs for the public, licensees and the police, and industry funding for harm-minimisation programs.

Alcohol Drinking↗
PubMed1994

The PCL2 (ORFD)-PHO85 cyclin-dependent kinase complex: a cell cycle regulator in yeast.

Cyclin-dependent kinase (cdk) complexes are essential activators of cell cycle progression in all eukaryotes. In contrast to mammalian cells, in which multiple cdk's contribute to cell cycle regulation, the yeast cell cycle is largely controlled by the activity of a single cdk, CDC28. Analysis of the putative G1 cyclin PCL2 (ORFD) identified a second cyclin-cdk complex that contributes to cell cycle progression in yeast. PCL2 interacted with the cdk PHO85 in vivo and in vitro and formed a kinase complex that had G1-periodic activity. Under genetic conditions in which the Start transition was compromised, PHO85 and its associated cyclin subunits were essential for cell cycle commitment. Because PHO85 and another cyclin-like molecule, PHO80, also take part in inorganic phosphate metabolism, this cdk enzyme may integrate responses to nutritional conditions with the cell cycle.

CDC28 Protein Kinase, S cerevisiae↗
PubMed1994

Familial Dandy-Walker malformation associated with macrocephaly, facial anomalies, developmental delay, and brain stem dysgenesis: prenatal diagnosis and postnatal outcome in brothers. A new syndrome?

Brothers are reported with an apparently new constellation of manifestations including Dandy-Walker complex (DWC), migrational brain disorder, macrocephaly, and facial anomalies. The first brother presented at birth, the second was detected prenatally with DWC and the pregnancy terminated. Fetal brain histopathology showed DWC associated with brainstem dysgenesis. Inheritance is likely autosomal or X-linked recessive. An extensive review of the differential diagnosis of DWC is provided.

Adult↗
PubMed1994

The relationship between traumatic exposure, family dysfunction, and post-traumatic stress symptoms in male juvenile offenders.

This study examined some chronic, stressful conditions and some acute, traumatic events which may place youths at risk for specific types of psychopathology. Ninety one delinquent adolescents with histories of serious and repeated crimes were assessed for their exposure to 11 different types of trauma. The subjects were also tested using measures which assess family functioning, and frequency and intensity of Post-Traumatic Stress Disorder (PTSD) symptoms. Results indicated that 24% of the subjects tested met full DSM III-R criteria for PTSD. Both exposure to violence and family dysfunction were significantly associated with PTSD symptomatology. These findings suggest that juvenile offenders may constitute a high risk group for exposure to multiple types of trauma and the development of post-traumatic stress symptoms related to such exposure. This study provides a rationale for future cross-trauma research both within the juvenile offender population and between it and other identified trauma groups.

Adolescent↗
PubMed1994

Current changes in smoking attitudes and behaviours among adolescents in Wales, 1986-1992.

This paper presents data on recent trends in adolescent smoking in Wales. The data are drawn from four large-scale surveys conducted across the Principality in 1986, 1988, 1990 and 1992. The results show that there has been some success in delaying early experimentation with smoking, as well as some improvement in the attitudes of smokers towards their habit. Against this, there has been little change in smoking prevalence amongst both boys and girls, and cigarettes remained widely available for purchase by the under-16s. The implications of these findings for further action on smoking and the young are discussed.

Adolescent↗
PubMed1994

Plasma concentrations of FSH, LH, thyroid-stimulating hormone and growth hormone after exogenous stimulation with GnRH, TRH and GHRH in Booroola ewes that are homozygous carriers or non-carriers of the FecB gene.

The aim of the present study in Booroola ewes, either homozygous (BB) or non-carriers (++) of the FecB gene, was to test the specificity of the pituitary responses to exogenous hypothalamic releasing hormones by examining the plasma concentrations of FSH, LH, thyroid-stimulating hormone (TSH) and growth hormone (GH) after injecting the animals with different doses of GnRH, thyroid-releasing hormone (TRH) or growth-hormone-releasing hormone, (GHRH) which were administered on separate occasions. The animals (n = 8 per dose) received 0, 3.1 or 12.5 micrograms of thyroid-releasing hormone and GnRH (i.v.), whereas they (n = 9-13 per dose) received 0, 6.0 or 16.0 micrograms GHRH (i.v.). For each experiment there were no differences between the genotypes in bodymass or age. Gene-specific differences in the mean pretreatment concentrations of plasma FSH (BB > ++; P < 0.05) but not of LH, TSH or GH were noted. After treatment with GnRH, TRH or GHRH, significant effects of dose were noted for all the hormones; however, a gene-specific effect was observed only for FSH in response to GnRH (BB > ++; P < 0.01) with no genotype x dose interaction (ANOVA). For LH, the effects of genotype and the genotype x dose interaction almost reached significance at the 5% level (genotype, P = 0.055; genotype x dose, P = 0.067). For TSH and GH the respective genotype x dose interactions were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Effects of insulin-like growth factor-I peptides in rats with acute renal failure.

The effect of insulin-like growth factor-I (IGF-I) administration on body weight gain and the rate of recovery of renal function was investigated in rats following an acute episode of renal ischaemia. Since the des(1-3)IGF-I and LR3IGF-I variant forms of IGF-I have been shown to be more potent than IGF-I, their effects were also examined. Acute renal failure was produced in male Sprague-Dawley rats by clamping both renal arteries for 45 min. Treatment was commenced at the time of renal artery occlusion with vehicle (0.1 mol acetic acid/l; control group), IGF-I (2.0 mg/kg per day), des(1-3)IGF-I (2.0 mg/kg per day) or LR3IGF-I (1.5 mg/kg per day) by s.c. osmotic pump, and continued for 7 days, with rats being held in metabolism cages. Glomerular filtration rate (GFR) was estimated by the use of 51Cr-EDTA continuously infused i.p. via osmotic pump. Following the episode of renal ischaemia, body weight gain and nitrogen retention were significantly improved in all three peptide-treated groups, and serum urea concentrations were reduced in the groups treated with IGF-I and des(1-3)IGF-I. However, there was no evidence of the variants having any increased potency over the growth effects of IGF-I itself. GFR was significantly reduced, urine output was increased and urinary concentrating ability was reduced in all groups compared with normal rats, with no significant effect of the IGF peptides being apparent. A closer examination of the acute effects of LR3IGF-I on renal function was undertaken by measuring GFR for 3 days before and 3 days after renal ischaemia in two groups of rats, treated for the latter 3 days with either vehicle (controls) or LR3IGF-I (1.5 mg/kg per day). LR3IGF-I treatment following renal ischaemia resulted in a significantly greater fall in GFR than in controls, urinary osmolality was also significantly reduced, and fractional excretion of sodium was increased. In addition, there was histological evidence of a greater degree of tubular epithelial calcification in the kidneys of the rats treated with LR3IGF-I. This study showed that administration of IGF peptides at doses sufficient to cause significant improvement in anabolic status did not improve renal function in rats following an acute episode of renal ischaemia. Indeed the LR3IGF-I variant of IGF-I had a deleterious effect on renal function in the early stage of the recovery period.

Acute Kidney Injury↗
PubMed1994

Ultrasonography in obstetric and gynecologic emergencies.

In conclusion, both transabdominal and transvaginal sonography are valuable tools in the evaluation of the patient who presents with a gynecologic or obstetric emergency and can very quickly lead to a definitive diagnosis or limited differential. Sonography also can be useful in excluding the presence of other pathologies that may mimic obstetric or gynecologic disease including appendicitis, diverticulitis, and renal obstruction.

Diagnosis, Differential↗
PubMed1993

Making the internal market work: a case for managed change.

The internal market in the NHS is meant to ensure that provider units compete on the basis of price and quality and that money follows patients into efficient units. But the example of what happened to one local ophthalmology unit suggests what may go wrong when entrepreneurial activity is applied in a market that does not work perfectly. In 1991-2 the unit had a high workload but also comparatively high prices (because of crude pricing in the local hospital); because of pressure of work the waiting times lengthened and general practitioners increasingly complained about the service. The staff in the unit reopened a longstanding debate about the need for a third consultant ophthalmologist, but neither the purchasers (including fundholders) nor the provider unit were able to fund the post. Fundholders in a neighbouring district, however, together with that district health authority, decided to place their contracts elsewhere for the following year. Although the withdrawal of contracts jeopardised the clinical and financial viability of the ophthalmic unit, patients continued to use the service. When general practitioners in the district realised that their local service might collapse they pressed to keep the service open. The fundholders and the host purchaser finally agreed to fund a third consultant and drew up standards for the service. As a result the waiting times fell and the service is now described as "excellent." Short term market decisions may have unforseen long term implications for services to patients. This needs to be addressed as part of the evolution of the reformed NHS.

Costs and Cost Analysis↗
PubMed1993

Selective amplification of additional members of the ADP-ribosylation factor (ARF) family: cloning of additional human and Drosophila ARF-like genes.

The ADP-ribosylation factor (ARF) family is one of four subfamilies of the RAS superfamily of low molecular weight GTP-binding proteins (G proteins). Highly degenerate oligonucleotides encoding two conserved regions were used in a PCR reaction to amplify cDNAs encoding each of the known ARF proteins and eight additional cDNA fragments encoding previously unreported human members of the ARF family. Additional sequences were obtained from yeast or fly libraries by using this technique. These oligonucleotides specifically amplify members of the ARF family but not the structurally related G protein alpha subunits or members of the other three subfamilies of the RAS superfamily. Fragments obtained by PCR were used to obtain full-length sequences encoding highly homologous ARF-like (ARL) gene products from human and Drosophila melanogaster libraries, termed ARL2 and Ar184F, respectively. The encoded proteins are each 184 amino acids long and are 76% identical, with 40-45% identity to human ARF1 and Drosophila arf-like (arl) proteins. These genes appear to be generally expressed in human tissues and during Drosophila development. The purified human ARL2 protein differed in several biochemical properties from human ARF proteins, including the complete absence of ARF activity. Thus, the ARF family of low molecular weight GTP-binding proteins includes at least 15 distinct but structurally conserved members, including both the functionally conserved ARF proteins and the functionally disparate ARL proteins. The latter proteins currently comprise two distinct gene products in Drosophila (arl and ARL84F) and one in man (ARL2).

ADP-Ribosylation Factor 1↗