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Biomedical subjects

D Quinn

Publications and source records attributed to D Quinn.

At least 55 records · Page 3Linked to original sources
PubMed1991

Diagnosed intellectual and emotional impairment among parents who seriously mistreat their children: prevalence, type, and outcome in a court sample.

A substantial body of research evidence over the past three decades has indicated that intellectual and emotional impairment among parents is a factor contributing to child abuse and neglect. This study examined the court records of 206 seriously abused or neglected children and their families in a large urban area and found that in over half the records a parent had been diagnosed as having an emotional disorder and/or low IQ, with a majority of these diagnoses indicating significant impairment. Although type of impairment (emotional, low IQ, and a subsample of substance abusers) did not predict type of mistreatment, higher predicted risk for continued mistreatment, or greater likelihood of permanent removal of the child by the court, low IQ parents revealed significantly less prior court involvement and greater acceptance of court-ordered services. Parents diagnosed with serious emotional disorders were significantly more likely than less disturbed parents to have their children permanently removed despite findings of no significant differences in risk or compliance factors.

Affective Symptoms↗
PubMed1991

Substance abuse and serious child mistreatment: prevalence, risk, and outcome in a court sample.

This study examined the prevalence and specific types of substance abuse in a sample of 206 cases of serious child abuse or neglect brought before a metropolitan juvenile court on care and protection petitions. In 43% of the cases, at least one of the parents had a documented problem with either alcohol or drugs, a figure which rose to 50% when alleged instances of substance abuse were included. Alcohol, cocaine, and heroin were the three most frequently mentioned abused substances. Parents with documented substance abuse were significantly more likely than nonsubstance-abusing parents to have been referred previously to child protective agencies, to be rated by court investigators as presenting high risk to their children, to reject court-ordered services, and to have their children permanently removed. When the two factors of court investigator high risk ratings and presence of parental substance abuse were combined, it was possible to obtain even higher levels of prediction of which parents would reject services and have their children permanently removed. Results suggest (1) the importance of increased screening, evaluation, and treatment of parental substance abuse in cases of serious child mistreatment; and (2) the possibility of adopting a predictive approach as to which families will be able to respond to court-ordered treatment requests and have their children returned.

Alcoholism↗
PubMed1991

Extensive and enantioselective presystemic metabolism of dl-threo-methylphenidate in humans.

1. Two pilot studies were carried out to investigate the enantioselective pharmacokinetics of methylphenidate (MPH) in children with attention deficit-hyperactivity disorder (ADHD). A more definitive study, which included administration of an intravenous dose, was carried out in healthy young men. 2. Serial plasma samples were harvested from predose to 8 hours in the first pilot study, predose to 12 hours in the second pilot study and predose to 16 hours in the definitive study. Plasma levels of the separate isomers d-MPH and 1-MPH were determined by an enantioselective gas chromatographic method. 3. In the first pilot study, 6 boys with ADHD each received his regular dose of MPH (10mg n = 5, 5mg n = 1), which contained equal proportions of d-MPH and 1-MPH in an immediate release formulation (MPH-IR). No MPH was detectable in the predose plasma. Thereafter, plasma levels of the more active d-MPH were 4 to 10 fold higher than those of 1-MPH. Plasma levels of 1-MPH were so low that it was not possible to monitor them beyond 4 hours in some children. 4. In the second pilot study, 5 boys and 1 girl with ADHD each received their regular dose (20mg) of a slow release formulation (MPH-SR). No MPH was detectable in the predose plasma. Thereafter, plasma levels of the more active d-MPH were 5 to 10 fold higher than those of 1-MPH. It was possible to monitor plasma levels of 1-MPH over the full 12 hour period of study in 5 of the 6 children.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1991

Intracellular transport and sorting of mutant human proinsulins that fail to form hexamers.

Human proinsulin and insulin oligomerize to form dimers and hexamers. It has been suggested that the ability of prohormones to self associate and form aggregates may be responsible for the sorting process at the trans-Golgi. To examine whether insulin oligomerization is required for proper sorting into regulated storage granules, we have constructed point mutations in human insulin B chain that have been previously shown to prevent formation of insulin hexamers (Brange, J., U. Ribel, J. F. Hansen, G. Dodson, M. T. Hansen, S. Havelund, S. G. Melberg, F. Norris, K. Norris, L. Snel, A. R. Sorensen, and H. O. Voight. 1988. Nature [Lond.]. 333:679-682). One mutant (B10His----Asp) allows formation of dimers but not hexamers and the other (B9Ser----Asp) prevents formation of both dimers and hexamers. The mutants were transfected into the mouse pituitary AtT-20 cells, and their ability to be sorted into regulated secretory granules was compared to wild-type insulin. We found that while B10His----Asp is sorted somewhat less efficiently than wild-type insulin as reported previously (Carroll, R. J., R. E. Hammer, S. J. Chan, H. H. Swift, A. H. Rubenstein, and D. F. Steiner. 1988. Proc. Natl. Acad. Sci. USA. 85:8943-8947; Gross, D. J., P. A. Halban, C. R. Kahn, G. C. Weir, and L. Villa-Kumaroff. 1989. Proc. Natl. Acad. Sci. USA. 86:4107-4111). B9Ser----Asp is targeted to granules as efficiently as wild-type insulin. These results indicate that self association of proinsulin into hexamers is not required for its targeting to the regulated secretory pathway.

Amino Acid Sequence↗
PubMed1991

Gaining customer knowledge: obtaining and using customer judgments for hospitalwide quality improvement.

Customer knowledge is an essential feature of hospitalwide quality improvement. All systems and processes have customers. The aim is to use customer knowledge and voice of the customer measurement to plan, design, improve, and monitor these systems and processes continuously. In this way, the hospital stands the best chance of meeting customers' needs and, hopefully, delivering services that are so outstanding that customers will be surprised and delighted. There are many methods, both soft and hard, that can be used to increase customer knowledge. One useful strategy is to use a family of quality measures that reflect the voice of the customer. These measures can generate practical and powerful customer knowledge information that is essential to performing strategic planning, deploying quality policy, designing new services, finding targets for improvements, and monitoring those continuous improvements based on customers' judgments.

Consumer Behavior↗
PubMed1989

Enantioselective aspects of the disposition of dl-threo-methylphenidate after the administration of a sustained-release formulation to children with attention deficit-hyperactivity disorder.

It has been shown previously that immediate-release dl-threo-methylphenidate (Ritalin) undergoes stereoselective disposition in human adults as well as in children with attention deficit-hyperactivity disorder. Although the sustained-release formulation of dl-threo-methylphenidate (Ritalin-SR) has been demonstrated to be effective in sustaining the attention of the children with attention deficit-hyperactivity disorder, there are no data on plasma levels of methylphenidate after administration of the sustained-release formulation. The purpose of this present investigation was twofold: (1) to determine whether the levels of methylphenidate were sustained for over a time period of 8 h, and (2) to examine enantioselective aspects of the pharmacokinetics following the ingestion of the sustained-release formulation. Six children with attention deficit-hyperactivity disorder were given 20 mg of sustained-release dl-threo methylphenidate. Plasma samples were harvested for a period up to 12 h following ingestion of the drug. The levels of both the enantiomers were sustained for a period of 8 h (the plasma levels of d-methylphenidate were 8- to 10-fold higher than those of the l-enantiomer in the profiles of all six children). Mean areas under the plasma level time curves were 132.78 +/- 92.47 ng.h/mL for d-methylphenidate and 12.73 +/- 7.37 ng.h/mL for l-methylphenidate. The values of oral clearance and apparent volume of distribution calculated for l-enantiomer were higher than the corresponding values for the d-antipode.

Adolescent↗
PubMed1989

Bronchial artery ligation modifies pulmonary edema after exposure to smoke with acrolein.

Pulmonary edema can follow smoke inhalation and is believed to be due to the multiple chemical toxins in smoke, not the heat. We have developed a synthetic smoke composed of aerosolized charcoal particles to which one toxin at a time can be added to determine whether it produces pulmonary edema. Acrolein, a common component of smoke, when added to the synthetic smoke, produced a delayed-onset pulmonary edema in dogs in which the extravascular lung water (EVLW) as detected by a double-indicator technique began to rise after 42 +/- 2 (SE) min from 148 +/- 16 to 376 +/- 60 ml at 165 min after smoke exposure. The resulting pulmonary edema was widespread macroscopically but appeared focal microscopically with fibrin deposits in alveoli adjacent to small bronchi and bronchioles. Bronchial vessels were markedly dilated and congested. Monastral blue B when injected intravenously leaked into the walls of the bronchial vessels down to the region of the small bronchioles (less than or equal to 0.5 mm ID) of acrolein-smoke-exposed dogs but not into the pulmonary vessels. Furthermore, ligation of the bronchial arteries delayed the onset of pulmonary edema (87 +/- 3 min, P less than 0.05) and lessened the magnitude (232 +/- 30 ml, P less than 0.05) at 166 +/- 3 min after acrolein-smoke exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Acrolein↗
PubMed1987

Stereoselective disposition of methylphenidate in children with attention-deficit disorder.

Six boys with attention-deficit disorder were given single doses (5 or 10 mg) of dl-threo-methylphenidate (Ritalin, Ciba-Geigy, Basel, Switzerland). Plasma samples through 8 hr were analyzed by capillary column gas chromatography with electron capture detection. Enantiomers were separated and measured as heptafluorobutyryl-1-prolyl derivatives. The method was sensitive to 0.1 ng of enantiomer per ml of plasma. The plasma levels of d-methylphenidate were at least 5-fold greater than those of the l-enantiomer in the profiles of all six children. Mean areas under the plasma level-time curves were 24.48 +/- 7.62 ng/hr/ml for d-methylphenidate and 3.77 +/- 1.04 ng/hr/ml for l-methylphenidate. There was appreciable intersubject variation in plasma level maxima and times to maximal plasma levels of each enantiomer.

Adolescent↗
PubMed1986

Improved design of nasogastric feeding tubes.

Disappointed with the overall performance of weighted and unweighted nasogastric feeding tubes, a design programme was initiated which resulted in the development of two new nasogastric tubes, one weighted and one unweighted. The tubes were manufactured with polyurethane rather than polyvinylchloride (PVC) which permitted an increase in diameter of the internal lumen which in turn was coated with water activated lubricant to ease removal of the introducer wire. A specially modelled outflow port was incorporated into the tips of both tubes. The performance of the two new polyurethane nasogastric feeding tubes was assessed under controlled trial condition using as a reference a widely used PVC unweighted open ended tube. While intubation times were similar in patients without concurrent endotracheal intubation, it took a significantly shorter time to intubate patients with concurrent endotracheal intubation with the new weighted tube. Following tube intubation, it was possible to aspirate gastric contents significantly more often through the new polyurethane tubes (p < 0.001) than through the PVC tube, and the unweighted polyurethane tube stayed in situ longer (p < 0.05) than the PVC tube. The newly designed polyurethane nasogastric feeding tubes are the first tubes that have been shown to have advantages over the simpler type of open ended, unweighted PVC nasogastric feeding tubes.

Journal Article↗
PubMed1986

Defective interhemispheric integration and anomalous language lateralization in children at risk for schizophrenia.

The present study was carried out to determine whether children at risk for schizophrenia might exhibit abnormalities in test performance indicative of defective interhemispheric integration and abnormal specialization of language function. Twenty-two high-risk and 22 matched normal children were administered two independent tests of speech comprehension, delivered under monaural and binaural listening conditions, and a standard verbal dichotic listening test. On both comprehension tests the high-risk children exhibited significantly poorer binaural, relative to monaural, recall. On the verbal dichotic test the normal group exhibited a significant right ear advantage whereas for the high-risk group there was no significant difference between right and left ear recall. These results were taken to indicate abnormalities of both interhemispheric integration and language specialization in the high-risk group. Analyses indicate that these two abnormalities may be related in a specific fashion. The implications of these results are discussed within a developmental framework.

Adolescent↗