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Umotong E, Quinn E, Qadri S, Chandran R, Zacharias J. Acute successful management of a chainsaw injury to the roof of the left chest. Ann R Coll Surg Engl 2024; 106:291-294. [PMID: 37222711 PMCID: PMC10904260 DOI: 10.1308/rcsann.2022.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 05/25/2023] Open
Abstract
This case report chronicles the experience of prompt resuscitation, beginning with the patient, and immediate surgery following the fatal malfunction of a chainsaw. The injuries were atypical for chainsaw injuries and involved total transection of the left subclavian artery and vein, total transection of the left brachial plexus and laceration to the apex of the left lung, among other injuries. A coordinated effort allowed for successful repair of the life- and limb-threatening injuries so that the patient could return to his young family in time for his 40th birthday.
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Affiliation(s)
| | - E Quinn
- Salford Royal Foundation Trust, UK
| | - S Qadri
- Blackpool Victoria Hospital, UK
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2
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Keating D, Krengel M, Dugas J, Toomey R, Chao L, Steele L, Janulewicz LP, Heeren T, Quinn E, Klimas N, Sullivan K. Cognitive decrements in 1991 Gulf War veterans: associations with Gulf War illness and neurotoxicant exposures in the Boston Biorepository, Recruitment, and Integrative Network (BBRAIN) cohorts. Environ Health 2023; 22:68. [PMID: 37794452 PMCID: PMC10548744 DOI: 10.1186/s12940-023-01018-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND During deployment, veterans of the 1991 Gulf War (GW) were exposed to multiple war-related toxicants. Roughly a third of these veterans continue to exhibit neurotoxicant induced symptoms of Gulf War Illness (GWI), a multi-faceted condition that includes fatigue, pain and cognitive decrements. When studied empirically, both deployed veterans with exposures and those who meet the criteria for GWI are more likely to show deficits in the area of neuropsychological functioning. Although studies have shown cognitive impairments in small sample sizes, it is necessary to revisit these findings with larger samples and newer cohorts to see if other areas of deficit emerge with more power to detect such differences. A group of researchers and clinicians with expertise in the area of GWI have identified common data elements (CDE) for use in research samples to compare data sets. At the same time, a subgroup of researchers created a new repository to share these cognitive data and biospecimens within the GWI research community. METHODS The present study aimed to compare cognitive measures of attention, executive functioning, and verbal memory in a large sample of GWI cases and healthy GW veteran controls using neuropsychological tests recommended in the CDEs. We additionally subdivided samples based on the specific neurotoxicant exposures related to cognitive deficits and compared exposed versus non-exposed veterans regardless of case criteria status. The total sample utilized cognitive testing outcomes from the newly collated Boston, Biorepository, Recruitment, and Integrative Network (BBRAIN) for GWI. RESULTS Participants included 411 GW veterans, 312 GWI (cases) and 99 healthy veterans (controls). Veterans with GWI showed significantly poorer attention, executive functioning, learning, and short-and-long term verbal memory than those without GWI. Further, GW veterans with exposures to acetylcholinesterase inhibiting pesticides and nerve gas agents, had worse performance on executive function tasks. Veterans with exposure to oil well fires had worse performance on verbal memory and those with pyridostigmine bromide anti-nerve gas pill exposures had better verbal memory and worse performance on an attention task compared to unexposed veterans. CONCLUSIONS This study replicates prior results regarding the utility of the currently recommended CDEs in determining impairments in cognitive functioning in veterans with GWI in a new widely-available repository cohort and provides further evidence of cognitive decrements in GW veterans related to war-related neurotoxicant exposures.
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Affiliation(s)
- D Keating
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA, 02118, USA
| | - M Krengel
- Department of Neurology, Boston University School of Medicine, 72 East Concord St, Boston, MA, 02118, USA
| | - J Dugas
- Department of Biostatistics, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - R Toomey
- Department of Psychological and Brain Sciences, College of Arts and Sciences, Boston University, 900 Commonwealth Ave, Boston, MA, USA
| | - L Chao
- San Francisco Veterans Affairs Health Care System, University of California, San Francisco, CA, 94143, USA
| | - L Steele
- Baylor College of Medicine Neuropsychiatry Division, Department of Psychiatry and Behavioral Sciences, Houston, TX, 77030, USA
| | - Lloyd P Janulewicz
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA, 02118, USA
| | - T Heeren
- Department of Biostatistics, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - E Quinn
- Department of Biostatistics, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - N Klimas
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuroimmune Medicine, Nova Southeastern University, Fort Lauderdale, FL, 33314, USA
- Geriatric Research Education and Clinical Center, Miami VA Medical Center, Miami, FL, 33125, USA
| | - K Sullivan
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, T4W, Boston, MA, 02118, USA.
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Harris C, Whealdon C, Engelken J, Quinn E, Mornick C. Eating Competence is related to Health- and Weight-related Perceptions and Behaviors in Early Childhood Education Providers. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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4
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Keating D, Zundel CG, Abreu M, Krengel M, Aenlle K, Nichols MD, Toomey R, Chao LL, Golier J, Abdullah L, Quinn E, Heeren T, Groh JR, Koo BB, Killiany R, Loggia ML, Younger J, Baraniuk J, Janulewicz P, Ajama J, Quay M, Baas PW, Qiang L, Conboy L, Kokkotou E, O'Callaghan JP, Steele L, Klimas N, Sullivan K. Boston biorepository, recruitment and integrative network (BBRAIN): A resource for the Gulf War Illness scientific community. Life Sci 2021; 284:119903. [PMID: 34453948 DOI: 10.1016/j.lfs.2021.119903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/31/2021] [Accepted: 08/17/2021] [Indexed: 12/26/2022]
Abstract
AIMS Gulf War Illness (GWI), a chronic debilitating disorder characterized by fatigue, joint pain, cognitive, gastrointestinal, respiratory, and skin problems, is currently diagnosed by self-reported symptoms. The Boston Biorepository, Recruitment, and Integrative Network (BBRAIN) is the collaborative effort of expert Gulf War Illness (GWI) researchers who are creating objective diagnostic and pathobiological markers and recommend common data elements for GWI research. MAIN METHODS BBRAIN is recruiting 300 GWI cases and 200 GW veteran controls for the prospective study. Key data and biological samples from prior GWI studies are being merged and combined into retrospective datasets. They will be made available for data mining by the BBRAIN network and the GWI research community. Prospective questionnaire data include general health and chronic symptoms, demographics, measures of pain, fatigue, medical conditions, deployment and exposure histories. Available repository biospecimens include blood, plasma, serum, saliva, stool, urine, human induced pluripotent stem cells and cerebrospinal fluid. KEY FINDINGS To date, multiple datasets have been merged and combined from 15 participating study sites. These data and samples have been collated and an online request form for repository requests as well as recommended common data elements have been created. Data and biospecimen sample requests are reviewed by the BBRAIN steering committee members for approval as they are received. SIGNIFICANCE The BBRAIN repository network serves as a much needed resource for GWI researchers to utilize for identification and validation of objective diagnostic and pathobiological markers of the illness.
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Affiliation(s)
- D Keating
- Boston University School of Public Health, Department of Environmental Health, 715 Albany St. T4W, Boston, MA 02118, USA.
| | - C G Zundel
- Boston University School of Medicine, Behavioral Neuroscience Program, 72 East Concord St., Boston, MA 02118, USA.
| | - M Abreu
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuroimmune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; Geriatric Research Education and Clinical Center, Miami VA Medical Center, Miami, FL 33125, USA.
| | - M Krengel
- Boston University School of Medicine, Department of Neurology, 72 East Concord St., Boston, MA 02118, USA.
| | - K Aenlle
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuroimmune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; Geriatric Research Education and Clinical Center, Miami VA Medical Center, Miami, FL 33125, USA.
| | - M D Nichols
- Boston University School of Public Health, Department of Environmental Health, 715 Albany St. T4W, Boston, MA 02118, USA
| | - R Toomey
- Department of Psychological and Brain Sciences, College of Arts and Sciences, Boston University, 900 Commonwealth Ave., Boston, MA, USA.
| | - L L Chao
- San Francisco Veterans Affairs Health Care System, University of California, San Francisco, CA 94143, USA.
| | - J Golier
- James J. Peters VA Medical Center, OOMH-526, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Psychiatry Department, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, USA.
| | - L Abdullah
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL 34243, USA; Open University, Milton Keynes, United Kingdom; James A. Haley Veterans' Hospital, Tampa, FL, USA.
| | - E Quinn
- Boston University School of Public Health, Department of Biostatistics, 715 Albany St., Boston, MA 02118, USA.
| | - T Heeren
- Boston University School of Public Health, Department of Biostatistics, 715 Albany St., Boston, MA 02118, USA.
| | - J R Groh
- Boston University School of Medicine, Behavioral Neuroscience Program, 72 East Concord St., Boston, MA 02118, USA.
| | - B B Koo
- Boston University School of Medicine, Department of Anatomy and Neurobiology, 72 East Concord St., Boston, MA 02118, USA.
| | - R Killiany
- Boston University School of Public Health, Department of Environmental Health, 715 Albany St. T4W, Boston, MA 02118, USA; Boston University School of Medicine, Department of Neurology, 72 East Concord St., Boston, MA 02118, USA; Boston University School of Medicine, Department of Anatomy and Neurobiology, 72 East Concord St., Boston, MA 02118, USA.
| | - M L Loggia
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
| | - J Younger
- Neuroinflammation, Pain & Fatigue Lab, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - J Baraniuk
- Department of Medicine, Georgetown University, Washington, DC, USA.
| | - P Janulewicz
- Boston University School of Public Health, Department of Environmental Health, 715 Albany St. T4W, Boston, MA 02118, USA.
| | - J Ajama
- Boston University School of Public Health, Department of Environmental Health, 715 Albany St. T4W, Boston, MA 02118, USA.
| | - M Quay
- Boston University School of Public Health, Department of Environmental Health, 715 Albany St. T4W, Boston, MA 02118, USA.
| | - P W Baas
- Drexel University College of Medicine, Department of Neurobiology and Anatomy, 2900 Queen Lane, Philadelphia, PA 19129, USA.
| | - L Qiang
- Drexel University College of Medicine, Department of Neurobiology and Anatomy, 2900 Queen Lane, Philadelphia, PA 19129, USA.
| | - L Conboy
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA.
| | - E Kokkotou
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA.
| | - J P O'Callaghan
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
| | - L Steele
- Baylor College of Medicine Neuropsychiatry Division, Department of Psychiatry and Behavioral Sciences, Houston, TX 77030, USA.
| | - N Klimas
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuroimmune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; Geriatric Research Education and Clinical Center, Miami VA Medical Center, Miami, FL 33125, USA.
| | - K Sullivan
- Boston University School of Public Health, Department of Environmental Health, 715 Albany St. T4W, Boston, MA 02118, USA.
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Vaswani S, Quinn E, Novak D. 147 An Exploratory Study Investigating the Use of a Resident-Driven Virtual Webinar Series for Residency Program Recruitment. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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6
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Tarrant B, Quinn E, Robinson R, Poulsen M, Fuller L, Snell G, Thompson B, Button B, Holland A. Postoperative, Inpatient Rehabilitation after Lung Transplant Evaluation (PIRATE): A Feasibility Randomized Controlled Trial. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Protonotarios A, Quinn E, Dalageorgou C, Futema M, Akhtar MM, Asimaki A, Ashworth M, Savvatis K, Syrris P, Elliott PM, Lopes LR. P3686A novel desmin gene variant as an important cause of biventricular arrhythmogenic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Arrhythmogenic Cardiomyopathy (AC) is typically caused by mutations in the desmosomal genes, however non-desmosomal genes have been increasingly implicated. Desmin gene (DES) mutations have been previously reported in AC, but in many cases there are insufficient data to support their pathogenicity.
Purpose
We assessed our AC cohort for DES gene mutations and describe the clinical phenotype associated with a recurring variant present in 3 unrelated families.
Methods
Genetic testing was performed using next-generation sequencing for 41 genes in a total of 138 AC probands with a definite diagnosis of AC based on the revised 2010 Task Force diagnostic criteria. All candidate variants were confirmed using Sanger sequencing. Clinical and genetic cascade screening were expanded to the first-degree relatives of the probands. Retained tissue from deceased individuals was used for genetic testing. All living mutation carriers underwent clinical assessment including physical examination, 12-lead ECG, signal-averaged ECG, echocardiography, cardiac magnetic resonance imaging (MRI) and 24h Holter-monitoring.
Results
Two DES gene variants, p.Ser298Leu (n=1) and p.Leu115Ile (n=3), were identified in 4 out of the 138 probands (3%). The former coexisted with a pathogenic DSP gene mutation and has not been further evaluated. The latter is a novel variant, absent in control databases (gnomAD) and was the only variant present in 3 unrelated families (see figure). One carrier required heart transplant (A-II-1), two died suddenly (A-III-1, B-II-1) and one died of non-cardiac causes (B-I-2). Detailed clinical information was present in 8 mutation carriers (2 male, age 45±19 years). Seven (88%) had a definite diagnosis and one had a borderline diagnosis of AC. All cases (100%) had right ventricular (RV) wall motion abnormalities, 6 (75%) had a dilated RV, 6 (75%) a dilated LV and 6 (75%) had LV dysfunction (mild in 5 and severe in 1). LV late gadolinium enhancement (LGE) was present in all 6 carriers that had a cardiac MRI with a circumferential sub-epicardial distribution (see figure, case A-III-2). Non-sustained ventricular tachycardia (VT) was present in 7 (88%) and sustained VT in 2 cases (25%). The ventricular ectopic burden per 24h ranged from 426 to 10583 with a median value of 820.
Figure 1
Conclusion
Variants of the DES gene are rare causes of AC. The novel p.Leu115Ile variant seems to be prevalent in a large UK-based cohort and it causes a biventricular form of AC, with a characteristic scar pattern on MRI and severe outcomes.
Acknowledgement/Funding
Alexandros Protonotarios is supported by a BHF Clinical Research Training Fellowship no. FS/18/82/34024
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Affiliation(s)
- A Protonotarios
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - E Quinn
- St Bartholomew's Hospital, Inherited Cardiovascular Disease Unit, London, United Kingdom
| | - C Dalageorgou
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - M Futema
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - M M Akhtar
- St Bartholomew's Hospital, Inherited Cardiovascular Disease Unit, London, United Kingdom
| | - A Asimaki
- St George's University of London, Molecular and Clinical Sciences Research Institute, Cardiology Clinical Academic Group, London, United Kingdom
| | - M Ashworth
- Great Ormond Street Hospital for Children, Department of Pathology, London, United Kingdom
| | - K Savvatis
- St Bartholomew's Hospital, Inherited Cardiovascular Disease Unit, London, United Kingdom
| | - P Syrris
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - P M Elliott
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - L R Lopes
- St Bartholomew's Hospital, Inherited Cardiovascular Disease Unit, London, United Kingdom
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Hughes RK, Camaioni C, Knott KD, Quinn E, Captur G, Syrris P, Kellman P, Elliott PM, Mohiddin S, Xue H, Lopes L, Moon J. 267Myocardial perfusion defects in genotype-positive hypertrophic cardiomyopathy without left ventricular hypertrophy. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R K Hughes
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - C Camaioni
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - K D Knott
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - E Quinn
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - G Captur
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - P Syrris
- University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - P Kellman
- National Institutes of Health, Bethesda, United States of America
| | - P M Elliott
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - S Mohiddin
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - H Xue
- National Institutes of Health, Bethesda, United States of America
| | - L Lopes
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Moon
- St Bartholomew"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
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Murphy L, Quinn E, O'leary D, Razzaq Z, Livingstone V, Redmond H, Corrigan M. Assessing the accuracy of MRI in measuring nodal response to neoadjuvant chemotherapy (NAC) in breast cancer. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30524-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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10
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Quinn E, O’Hara BJ, Ahmed N, Winch S, McGill B, Banovic D, Maxwell M, Rissel C. Enhancing the get healthy information and coaching service for Aboriginal adults: evaluation of the process and impact of the program. Int J Equity Health 2017; 16:168. [PMID: 28877697 PMCID: PMC5586001 DOI: 10.1186/s12939-017-0641-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-communicable chronic diseases in Australia contribute to approximately 85% of the total burden of disease; this proportion is greater for Aboriginal communities. The Get Healthy Service (GHS) is effective at reducing lifestyle-based chronic disease risk factors among adults and was enhanced to facilitate accessibility and ensure Aboriginal cultural appropriateness. The purpose of this study is to detail how formative research with Aboriginal communities was applied to guide the development and refinement of the GHS and referral pathways; and to assess the reach and impact of the GHS (and the Aboriginal specific program) on the lifestyle risk factors of Aboriginal participants. METHODS Formative research included interviews with Aboriginal participants, leaders and community members, healthcare professionals and service providers to examine acceptability of the GHS; and contributed to the redesign of the GHS Aboriginal program. A quantitative analysis employing a pre-post evaluation design examined anthropometric measures, physical activity and fruit and vegetable consumption of Aboriginal participants using descriptive and chi square analyses, t-tests and Wilcoxon signed-rank tests. RESULTS Whilst feedback from the formative research was positive, Aboriginal people identified areas for service enhancement, including improving program content, delivery and service promotion as well as ensuring culturally appropriate referral pathways. Once these changes were implemented, the proportion of Aboriginal participants increased significantly (3.2 to 6.4%). There were significant improvements across a number of risk factors assessed after six months (average weight loss: 3.3 kg and waist circumference reduction: 6.2 cm) for Aboriginal participants completing the program. CONCLUSIONS Working in partnership with Aboriginal people, Elders, communities and peak bodies to enhance the GHS for Aboriginal people resulted in an enhanced culturally acceptable and tailored program which significantly reduced chronic disease risk factors for Aboriginal participants. Mainstream telephone based services can be modified and enhanced to meet the needs of Aboriginal communities through a process of consultation, community engagement, partnership and governance.
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Affiliation(s)
- E. Quinn
- Public Health Unit, Sydney Local Health District, Level 9, King George Building, RPAH, Missenden Road, Camperdown, 2050 Australia
| | - B. J. O’Hara
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Level 6, The Hub, Charles Perkins Centre D17, 2006 Camperdown, Australia
| | - N. Ahmed
- NSW Office of Preventive Health, NSW Ministry of Health, Liverpool Hospital, Level 1, Don Everett Building, West End, Elizabeth Street, Liverpool, NSW 2170 Australia
| | - S. Winch
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2540 Australia
| | - B. McGill
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Level 6, The Hub, Charles Perkins Centre D17, 2006 Camperdown, Australia
| | - D. Banovic
- Planning Unit, Sydney Local Health District, KGV Missenden Road, Camperdown, NSW 2050 Australia
| | - M. Maxwell
- Centre for Population Health, NSW Ministry of Health, 73 Miller Street, North Sydney, 2060 Australia
| | - C. Rissel
- NSW Office of Preventive Health, NSW Ministry of Health and Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Camperdown, Australia
- NSW Office of Preventive Health, Liverpool Hospital, Level 1, Don Everett Building, West End, Elizabeth Street, Liverpool, NSW 2170 Australia
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Udintsev V, Maquet P, Alexandrov E, Casal N, Cuenca D, Drevon JM, Feder R, Friconneau J, Giacomin T, Guirao J, Iglesias S, Josseaume F, Levesy B, Loesser D, Ordieres J, Quinn E, Pak S, Penot C, Pitcher C, Portalès M, Proust M, Suarez A, Seyvet F, Tanchuk V, Utin Y, Vacas C, Vasseur C, Walsh M. Final design of the generic equatorial port plug structure for ITER diagnostic systems. Fusion Engineering and Design 2015. [DOI: 10.1016/j.fusengdes.2015.05.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Trostanetsky A, Kostyukovsky M, Quinn E. Transovarial Effect of Novaluron on Tribolium castaneum (Coleoptera: Tenebrionidae) After Termination of Direct Contact. J Insect Sci 2015; 15:125. [PMID: 26363061 PMCID: PMC4672219 DOI: 10.1093/jisesa/iev109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Abstract
The insect growth regulator novaluron (Rimon 10 EC, Makhteshim-Agan Ltd, Israel) is used against many field pests on corn, vegetables, orchards, forests, and cotton plantations. Previously, we studied various effects of novaluron on stored grain pests. Termination in Tribolium castaneum (Herbst) eggs hatching after treating adults with novaluron and following restoration after adult transfer to untreated media was observed. The objective of this study was to investigate the restoration of T. castaneum egg hatch following transfer of adults from treated media to untreated favorable and unfavorable media. The time needed for hatching restoration of 50% of eggs laid by adults transferred from novaluron (1 ppm) treated flour to untreated flour (RT50) was 2.7 d. RT50 for those transferred to untreated wheat grain was 4.1 d. RT90 in flour was 3.6 d, in grain--6.1 d. Varieties of RTs in grain and in flour with nonoverlapping confidence intervals indicate that RTs were significantly different. Delay of eggs hatching restoration for adults transferred from treated flour to unfavorable media (Petri dishes with limited amount of flour, lying of eggs not detected) was observed. RT50 in flour was 2.1 d and RT90--3.1 d, while RT50 in the unfavorable media was 3.4 d and RT90 6.5 d. Delayed effect of egg hatching restoration after adult transfer to unfavorable media provides evidence of the significant role of insect physiological state in novaluron excretion and (or) degradation by T. castaneum females.
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Affiliation(s)
- A Trostanetsky
- Department of Food Quality and Safety, ARO, The Volcani Center, Bet Dagan, 50250, Israel
| | - M Kostyukovsky
- Department of Food Quality and Safety, ARO, The Volcani Center, Bet Dagan, 50250, Israel
| | - E Quinn
- Department of Food Quality and Safety, ARO, The Volcani Center, Bet Dagan, 50250, Israel
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Urada LA, Raj A, Cheng DM, Quinn E, Bridden C, Blokhina EA, Krupitsky E, Samet JH. History of intimate partner violence is associated with sex work but not sexually transmitted infection among HIV-positive female drinkers in Russia. Int J STD AIDS 2013; 24:287-92. [PMID: 23970660 DOI: 10.1177/0956462412472809] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper assesses the associations between intimate partner violence (IPV) and sexually transmitted infections (STIs) and sexual risks among HIV-positive female drinkers in St Petersburg, Russia. Survey and STI data were analysed from 285 women in HERMITAGE, a secondary prevention study of HIV-positive heavy drinkers. Logistic and Poisson regression analyses assessed associations of IPV with STI and risky sex. Most women (78%) experienced IPV and 19% were STI positive; 15% sold sex. IPV was not significantly associated with STI, but was with selling sex (adjusted odds ratio = 3.56, 95% confidence interval = 1.02-12.43). In conclusion, IPV is common and associated with sex trade involvement among Russian HIV-positive female drinkers.
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Affiliation(s)
- L A Urada
- Division of Global Public Health, Department of Medicine, University of California - San Diego School of Medicine, San Diego, CA 92093-0507, USA.
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Phillips KA, Menard W, Quinn E, Didie ER, Stout RL. A 4-year prospective observational follow-up study of course and predictors of course in body dysmorphic disorder. Psychol Med 2013; 43:1109-1117. [PMID: 23171833 DOI: 10.1017/s0033291712001730] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND This report prospectively examines the 4-year course, and predictors of course, of body dysmorphic disorder (BDD), a common and often severe disorder. No prior studies have prospectively examined the course of BDD in individuals ascertained for BDD. Method The Longitudinal Interval Follow-Up Evaluation (LIFE) assessed weekly BDD symptoms and treatment received over 4 years for 166 broadly ascertained adults and adolescents with current BDD at intake. Kaplan-Meier life tables were constructed for time to remission and relapse. Full remission was defined as minimal or no BDD symptoms, and partial remission as less than full DSM-IV criteria, for at least 8 consecutive weeks. Full relapse and partial relapse were defined as meeting full BDD criteria for at least 2 consecutive weeks after attaining full or partial remission respectively. Cox proportional hazards regression examined predictors of remission and relapse. RESULTS Over 4 years, the cumulative probability was 0.20 for full remission and 0.55 for full or partial remission from BDD. A lower likelihood of full or partial remission was predicted by more severe BDD symptoms at intake, longer lifetime duration of BDD, and being an adult. Among partially or fully remitted subjects, the cumulative probability was 0.42 for subsequent full relapse and 0.63 for subsequent full or partial relapse. More severe BDD at intake and earlier age at BDD onset predicted full or partial relapse. Eighty-eight percent of subjects received mental health treatment during the follow-up period. CONCLUSIONS In this observational study, BDD tended to be chronic. Several intake variables predicted greater chronicity of BDD.
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Affiliation(s)
- K A Phillips
- Rhode Island Hospital, Providence, RI 02903, USA.
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Harrold JA, Hughes GM, O'Shiel K, Quinn E, Boyland EJ, Williams NJ, Halford JCG. Acute effects of a herb extract formulation and inulin fibre on appetite, energy intake and food choice. Appetite 2012. [PMID: 23207186 DOI: 10.1016/j.appet.2012.11.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The impact of two commercially available products, a patented herb extract Yerbe Maté, Guarana and Damiana (YGD) formulation and an inulin-based soluble fermentable fibre (SFF), alone or in combination, on appetite and food intake were studied for the first time in a double blind, placebo-controlled, cross-over design. 58 normal to slightly overweight women consumed a fixed-load breakfast followed 4h later by an ad libitum lunch. They were administered YGD (3 tablets) and SFF (5g in 100ml water), YGD and water (100ml), SFF and placebo (3 tablets) or water and placebo 15min before meals. Appetite was assessed using visual analogue scales, and energy intake was measured at lunch. Significant reductions in food intake and energy intake were observed when YGD was present (59.5g, 16.3%; 112.4kcal, 17.3%) and when SFF was present (31.9g, 9.1%; 80kcal, 11.7%) compared with conditions were products were absent. The lowest intake (gram and kcal) was in the YGD+SFF condition. Significant reductions in AUC hunger and AUC desire to eat were also observed after YGD+SFF combination. The data demonstrate that YGD produces a robust short-term effect on caloric intake, an effect augmented by SFF. Caloric compensation for SFF indicates independent effects on appetite regulation.
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Affiliation(s)
- J A Harrold
- Kissileff Laboratory for the Study of Human Ingestive Behaviour, Department of Experimental Psychology, Institute of Psychology, Health and Society, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, UK.
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Biggart S, Chin D, Fauchon M, Cardew G, du Fou L, Harker N, Quinn E, Keller C, Vincent R, Mayne L. Association of genetic polymorphisms in the ACE, ApoE, and TGF beta genes with early onset ischemic heart disease. Clin Cardiol 2009; 21:831-6. [PMID: 9825196 PMCID: PMC6656254 DOI: 10.1002/clc.4960211109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The genetic factors that contribute to ischemic heart disease (IHD) are poorly understood, and it is likely that multiple genes acting independently or synergistically contribute to the risk of IHD and outcome. The genes for angiotensin-converting enzyme (ACE) and apolipoprotein E (ApoE) have been implicated independently in the risk of IHD. HYPOTHESIS This study examined whether genetic polymorphisms in the ACE and ApoE genes are associated with early onset IHD. Polymorphisms in a third gene, transforming growth factor beta 2 (TGF beta 2), with a known role in wound repair and cardiac development, are also examined with respect to early onset IHD. METHODS In all, 101 patients with IHD and onset of disease before 55 years for men and 60 years for women, and 100 controls with angiographically confirmed normal coronary arteries were recruited for this study. The ACE, ApoE, and TGF beta 2 genotypes were determined by polymerase chain reaction amplification or Southern blotting and were compared with the patient's clinical and family histories. RESULTS AND CONCLUSION The frequency of the ACE D allele was significantly lower in the patient group (0.475) than in the control group (0.59, p = 0.03), which was attributed to a reduction in the number of patients with the DD genotype (patients: 24% DD, controls: 33% DD). Sudden cardiac death was also associated with the DD genotype. These data are consistent with the ACE D allele contributing to a fatal outcome. No association between the DD genotype and risk of myocardial infarction, presenting age, extent of vessel disease, family history, hypertension, or hypercholesterolemia was seen. Analysis of the ApoE genotype showed no association with early onset IHD. There was no evidence for a synergistic effect between the ACE and ApoE genotypes on the risk of early onset IHD. A polymorphism in the TGF beta 2 gene was rare and not associated with early onset IHD.
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Affiliation(s)
- S Biggart
- Cardiac Department, St. Thomas's Hospital, London, United Kingdom
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17
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Quinn E, Salter J, Hills M, Dowsett M. Concordance between tissue microarray and whole tissue sections for ER expression and PgR and HER-2 status: a pilot study for the Trans-ATAC trial. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70627-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Quinn E, Hawkins N, Yip YL, Suter C, Ward R. CD103+ intraepithelial lymphocytes--a unique population in microsatellite unstable sporadic colorectal cancer. Eur J Cancer 2003; 39:469-75. [PMID: 12751377 DOI: 10.1016/s0959-8049(02)00633-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Colorectal cancers with microsatellite instability (MSI) typically show increased numbers of intraepithelial lymphocytes (IEL) in comparison to microsatellite stable (MSS) cancers. The aim of this study was to determine the phenotype of this unique lymphocyte population in MSI and MSS colorectal cancers. Twenty-four individuals with sporadic colorectal cancer (17 MSI, 7 MSS) were included in this study. Intraepithelial and stromal lymphocytes were detected using immunohistochemistry with anti-CD8 and anti-CD103 antibodies, and two observers independently quantified the numbers of lymphocytes. CD103+ (alpha E beta 7+) IELs detected within tumour tissue co-expressed CD8+ while the stromal lymphocytes were phenotypically heterogeneous, with respect to CD8+ and CD103+ expression. MSI colorectal cancers harboured increased numbers of CD8+ CD103+ IELs, as well as CD8+ CD103- and CD8+ CD103+ stromal lymphocytes, when compared with MSS colorectal cancers. CD103+ IELs were found at 27-fold greater numbers in the tumour epithelium than in normal epithelium from the same patient (P = 0.001, Wilcoxon matched pairs test). From our findings, we have proposed a mechanism for the homing of these alpha E beta 7+ lymphocytes to tumour tissue in MSI and MSS colorectal cancers.
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Affiliation(s)
- E Quinn
- Department of Medical Oncology, St Vincent's Hospital, School of Microbiology and Immunology, University of New South Wales, Australia
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19
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Abstract
The study aimed to determine if melatonin could reliably induce sleep in children undergoing sleep EEG without affecting the usefulness of the EEG itself. One hundred and sixty three children (112 males, 51 females; mean age 8 years, range 1 to 16 years) referred for sleep EEG were studied. The children were given 2 to 10 mg of melatonin, depending on age, just before EEG recording. Measurements included sleep-onset latency, adverse effects, and acceptability of the EEG. Usefulness and acceptability of melatonin-induced sleep EEG were compared with the standard technique of sleep EEG following sleep deprivation in 30 children (matched for sex and age). Sleep was obtained in 79% of the 163 children who received melatonin after an average of 33 minutes. Yield of epileptiform abnormalities demonstrated in the melatonin sleep EEG was similar to that reported in the literature for sleep-deprived EEGs. There was no significant adverse effect. When compared, a melatonin-induced sleep EEG was as useful as a sleep-deprived EEG. However, the children's behaviour on the day of the melatonin-induced sleep EEG recording was more acceptable to parents.
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Affiliation(s)
- E Wassmer
- Department of Neurology, Birmingham Children's Hospital, UK
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Abstract
OBJECTIVE To determine the efficacy of melatonin in obtaining sleep electroencephalograms in children. METHODS Melatonin was used in 68 unselected children referred to the neurophysiology department for sleep electroencephalogram (EEG). A group of 68 children matched for age and sex who underwent EEGs after sleep deprivation in the same period was used as control. Sleep latency, as well as latency from stage 1 to stages 2, 3 and 4 were measured. RESULTS No difference in the number of children who went to sleep was seen. No significant difference is the macrostructure of sleep was seen, other than a reduced sleep latency for the melatonin group (P<0.01). CONCLUSION The study suggests that melatonin can reliably be used for obtaining sleep EEGs in children. Its use seems to provide a good alternative to pharmacological sedation and a complementary method to sleep deprivation.
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Affiliation(s)
- E Wassmer
- Department of Neurology, The Birmingham Children's Hospital NHS Trust, Birmingham, UK
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21
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Hughes A, Coulter F, Gillespie R, Livingston H, Phillips K, Quinn E, Rimmer E, Smith M, Walker A. Anticholinesterases in the treatment of Alzheimer's dementia--the first year's experience in Argyll & Clyde. Health Bull (Edinb) 2000; 58:20-4. [PMID: 12813848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The local experience of the introduction of a new anticholinesterase treatment for Alzheimer's dementia is described, including the use of a protocol to introduce the use of these drugs. The results in the first 233 patients seen are reported. The protocol seemed to anticipate SMAC. guidelines and to be easy to operate; the drug appeared to have clear clinical effect.
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Affiliation(s)
- A Hughes
- Renfrewshire Healthcare NHS Trust
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22
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Abstract
The aim of this study was to ascertain the acceptability of sleep-deprived EEGs to parents and their young child. Fifty unselected children having a sleep-deprived EEG were recruited. Data were collected from a sleep diary, a parent questionnaire and the request form of the EEG. Data collected covered developmental, learning and behavioural problems and the acceptability of the sleep-deprived EEG. There were 29 males (58%) in the study group. The average age was 8.6 years (range 2-17 years). Fifty percent of parents found it difficult to keep their child awake at night and 30% of parents found it difficult to wake their child in the morning. Fifty-four percent of parents reported their child had difficult behaviour on the day of the EEG. None had seizures provoked by sleep deprivation.
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Affiliation(s)
- E Wassmer
- Department of Paediatric Neurology and Clinical Neurophysiology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B6 4NH, UK
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23
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Quinn E, Paradise K, Atema J. Juvenile Limulus polyphemus Generate Two Water Currents That Contact One Proven and One Putative Chemoreceptor Organ. Biol Bull 1998; 195:185-187. [PMID: 28570188 DOI: 10.2307/1542829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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More R, Moore K, Quinn E, Perez Avila C, Davidson C, Vincent R, Chamberlain D. Delay times in the administration of thrombolytic therapy: the Brighton experience. Int J Cardiol 1995; 49 Suppl:S39-46. [PMID: 7591316 DOI: 10.1016/0167-5273(95)02338-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We reviewed the effectiveness of a strategy involving paramedic ambulances and community education to reduce the delay to thrombolytic therapy in patients admitted with acute myocardial infarction, by analysing delay times recorded during routine treatment. Rapid identification and treatment of patients with acute myocardial infarction who were eligible for thrombolysis was carried out in the Accident and Emergency and Cardiac Care Units. Two hundred seventy-four patients were admitted with acute myocardial infarction over an 18-month period and treated with anistreplase (168) or streptokinase (106). The following median times were recorded: symptom onset to administration of thrombolytic therapy, 142 min (range 43-980 min); symptom onset to ambulance arrival, 60 min; ambulance with patient to arrival in hospital, 35 min; time to treatment in hospital ('door to needle time'), 25 min; in-hospital delays were notably shorter for patients given anistreplase as opposed to streptokinase. Shortened delays for the delivery of thrombolytic therapy can be achieved by a strategy involving public education, the availability of resuscitation ambulances, and close liaison with the Accident and Emergency Department.
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Affiliation(s)
- R More
- Department of Cardiology, Royal Sussex County Hospital, Brighton, UK
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26
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Healy M, O’Moore R, Keane EM, Coakley D, Walsh JB, Tully M, Swanwick G, Coen R, Bruce I, O’Mahony D, Radic A, O’Kelly F, O’Doherty M, Lawlor BA, Lee H, Conway J, Keane E, Ng K, Murphy S, Khaw KT, May H, Compston JE, Taggart H, Crawford V, Twomey C, Delaney L, Crowley M, Hyland M, Hegarty V, Donovan MC, Pye M, Reardon M, Coleman P, Hyland CM, Scott T, Keane CT, Farragher B, O’Connor A, Quinn E, Mahony D, Rowan M, Buggy F, Freyne A, Wrigley M, Passmore AP, Crawford VLS, Beringer TRO, Gilmore DH, Hussain A, Grant D, Montgomery A, Hemeryck L, McCormack PME, Sheehan N, Guely A, Leonard L, Caulfield D, Nic Cártaigh M, Feely J, Mulkerrin E, Clark BA, Epstein FH, Keane N, McCabe E, Shepherd M, O’Donnell MJ, Cooper RA, Nurzaman M, Brooks RW, Sinha SK, Kane D, McKiernan M, Crowe J, Lennon J, Sheehan J, Rearden M, Hyland M, Tracey F, Lawson JT, Stout RW, Williams H, Naguib M, O’Keefe S, Lavan J, Madigan SM, McNulty H, Eaton-Evans J, Strain JJ, Stanwick G, Horgan F, Keating D, Crowe M, McNamara A, Leahy P, Healy S, Moraes D, Tyrell J, Crawford VLS, O’Keeffe S, Glasgow R, Tormey W, Finucane P, Nair BK, McCann C, Coen RF, O’Boyle CA, Joyce CRB, Hiltbrunner B, Clarke R, Cooney J. Irish Gerontological Society. Ir J Med Sci 1994. [DOI: 10.1007/bf02940568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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27
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Kent A, Keenan AK, Herity NA, Allen JD, Silke B, Adgey AAJ, O’Halloran KD, Curran AK, Bradford A, Craig JA, Barlas P, Baxter GD, Walsh DM, Allen JM, Logan ID, Wilkinson YA, McKenna PG, Brayden DJ, Dunne J, Baird AW, Kelly JG, O’Connor JJ, Rowan MJ, Anwyl R, Caldwell M, Earley B, Leonard BE, Wedlock PM, Shephard RA, Bracken PJ, Fitzpatrick JM, O’Reilly C, Quinn E, Ryan MP, O’Neill J, Kernan RP, Craven CD, Healy E, Clarke H, Nolan CA, O’Connell C, Deegan PM, Abdelwahab YHA, Barnett CR, Flatt PR, MacSweeney C, Kelly JP, Cawley T, Geraghty J, Osborne H, Docherty JR, Nelson AA, McDowell BC, McCrory M, Deasy PB, Finan MP, Klatt PR, Hornykiewytsch T, Campion DP, Leek BF, Sharma SC, Barry-Kinsella C, Foran K, Thomas G, McKinney MW, O’Connor J, McKelvey-Martin VJ, Thompson CCM, McCarthy PJ, Hannigan BM, Thurnham DI, Chopra M, Leake D, Sheehy PJA, Delanty N, Murphy N, Lawson JA, FitzGerald GA, Fitzgerald DJ, Smyth EM, McCole D, O’Neill M, Canney M, Turley E, Strain JJ, Gallagher GA, Shields TD, O’Kane S, Eason SJ, Gilmore WS, King CM, Hejmadi M, McKeown SR, McAleer JJA, Patterson LH, Gray PSC, Lappin TRJ, Bridges JM, Richardson SAM, Murphy PG, Davidson N, Hooper ACB. Royal Academy of Medicine in Ireland Section of Biomedical Sciences Proceedings of Summer Meeting held 22nd & 23rd June, 1993. Ir J Med Sci 1994. [DOI: 10.1007/bf02965965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
OBJECTIVE To assess the impact of extended training in advanced life support on the outcome of resuscitation. DESIGN Analysis of the successful resuscitations from 1981 to 1989. SETTING Brighton and East Sussex. RESULTS 248 patients were resuscitated from cardiac or respiratory arrest in the community and subsequently survived to leave hospital. Their mean age was 64 years and one year survival was 77%. In most cases the cause of collapse was cardiac but 38 (15%) suffered a respiratory arrest. In 140 of the successful resuscitations (56%) collapse occurred before the arrival of the ambulance. Basic life support, with ventilation and chest compression where necessary, was sufficient to revive 35 (14%) of the patients. Defibrillation was also required in 107 patients (43%), and in a further 106 patients (43%) who had prolonged cardiorespiratory arrest requiring endotracheal intubation and the use of several drugs. Review of ambulance forms and case notes showed that in 87 cases (35%) the abilities of the paramedical ambulance staff in advanced resuscitation techniques contributed decisively to the success of resuscitation. These skills are illustrated by eight case reports. CONCLUSIONS Extended training for ambulance staff increases the likelihood of successful resuscitation from out-of-hospital cardiopulmonary arrest. Though instruction in defibrillation must have the highest priority, full paramedical training can bring appreciable additional benefits.
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Affiliation(s)
- S J Lewis
- Cardiology Department, Royal Sussex County Hospital, Brighton
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Nelson L, Swearingen G, Sing M, Quinn E. Medigap preferred provider organizations: issues, implications, and early experience. Health Care Financ Rev 1991; 12:87-97. [PMID: 10112769 PMCID: PMC4193199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Health Care Financing Administration is sponsoring the Medicare Physician Preferred Provider Organization (PPO) Demonstration to assess the feasibility and desirability of including a PPO option under Medicare. Two sites are currently operational. At one site, Blue Cross and Blue Shield of Arizona is offering a PPO linked with a medigap insurance plan. This "medigap PPO" and its initial experience are described, and a preliminary assessment of the viability and effectiveness of medigap PPOs nationally is provided. Impediments to the development and effectiveness of medigap PPOs are identified and possible government actions discussed.
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Affiliation(s)
- L Nelson
- Mathematica Policy Research, Inc., Washington, DC 20024
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Abstract
Transcutaneous cardiac pacing using the Pace-Aid (Cardiac Resuscitator Corporation) was assessed in 32 emergency patients presenting with profound bradycardia or asystole who had failed to recover with advanced life support including the use of epinephrine. Pacing stimuli, pulse width 20 ms at 50, 100, or 200 mA, were delivered through two 8 cm gel-pad electrodes placed antero-posteriorly on the chest. By ECG criteria, definite electrical capture was achieved in a total of five patients and possible capture in a further 16. Of the 21 patients presenting in asystole 11 showed possible electrical capture only. No evidence of capture was seen in one third of the patients studied. Use of the Pace-Aid resulted in a palpable pulse in a total of seven patients. Four of the 11 patients with profound bradycardia survived to receive temporary transvenous pacing; two were eventually discharged. None in the asystolic group survived. Difficulties in using the Pace-Aid resulted from electrical overload by the pacing impulse that obscured the evidence for electrical capture, and intense muscle contraction that hindered reliable palpation of the arterial pulse. Transcutaneous pacing can occasionally be of value even at a late stage in the emergency treatment of profound bradycardia but is unlikely to be worthwhile in complete asystole.
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Affiliation(s)
- E Rosenthal
- Department of Cardiology, Royal Sussex County Hospital, Brighton, UK
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Fan W, del Busto R, Love M, Markowitz N, Cendrowski C, Cardenas J, Quinn E, Saravolatz L. Imipenem-cilastatin in the treatment of methicillin-sensitive and methicillin-resistant Staphylococcus aureus infections. Antimicrob Agents Chemother 1986; 29:26-9. [PMID: 3460521 PMCID: PMC180357 DOI: 10.1128/aac.29.1.26] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Imipenem-cilastatin was evaluated for efficacy and toxicity as an antistaphylococcal agent in 23 patients; 11 of these patients were infected with methicillin-resistant Staphylococcus aureus (MRSA), and 12 were infected with methicillin-susceptible S. aureus (MSSA). There were 15 soft tissue, 5 endovascular, and 3 skeletal infections and a total of nine patients with bacteremia. As determined by in vitro susceptibility testing, the MICs for 90% of the MRSA and MSSA isolates tested were 6.25 and 0.39 micrograms/ml, respectively. Two MRSA isolates were resistant to a concentration of greater than 16 micrograms/ml. When 11 MRSA isolates and 7 MSSA isolates were incubated for 48 h the MICs for 90% of the isolates increased to greater than 50 micrograms/ml for the MRSA isolates and 6.25 micrograms/ml for the MSSA isolates. Three S. aureus isolates emerged resistant. Ten of 11 (91%) MRSA infections and 11 of 12 (92%) MSSA infections were clinically cured. Adverse reactions occurred in 25% of the imipenemcilastatin-treated patients. These reactions included gastrointestinal intolerance (7% of the patients), rash or pruritus (6%), eosinophilia (6%), thrombocytosis (4%), and a positive, direct Coomb test without hemolysis (3%). One of the two patients for whom therapy was discontinued because of gastrointestinal intolerance had antibiotic-associated colitis. Imipenem appears to be an effective antistaphylococcal agent against both MRSA and MSSA infections.
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Caldwell G, Millar G, Quinn E, Vincent R, Chamberlain DA. Simple mechanical methods for cardioversion: defence of the precordial thump and cough version. Br Med J (Clin Res Ed) 1985; 291:627-30. [PMID: 3928055 PMCID: PMC1417469 DOI: 10.1136/bmj.291.6496.627] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A prospective study was made of the value of the precordial thump and of cough version in life threatening ventricular arrhythmias. Of about 5000 medical and surgical patients, 68 were treated for persistent ventricular tachycardia and 248 for ventricular fibrillation, 86 of whom had presented outside hospital. Mechanical intervention was successful in 26 incidents occurring in 23 patients. Electrocardiographic records were obtained in 14 instances. Ventricular fibrillation was terminated by a thump in five patients and ventricular tachycardia by either a thump or a cough in a total of 17 patients. Four additional instances were recorded of successful recovery from asystolic or unspecified circulatory arrest after a precordial thump. Fifteen patients survived to be discharged from hospital. The potential benefit of the precordial thump and cough versions greatly outweighs their risks; hence these manoeuvres should probably be reintroduced into schedules for first aid resuscitation.
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Vincent R, Martin B, Williams G, Quinn E, Robertson G, Chamberlain DA. A community training scheme in cardiopulmonary resuscitation. Br Med J (Clin Res Ed) 1984; 288:617-20. [PMID: 6421403 PMCID: PMC1444340 DOI: 10.1136/bmj.288.6417.617] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Community instruction in basic life support and resuscitation techniques has been offered in Brighton Health District since 1978. Classes are held frequently for the general public and businesses, schools, and other organisations. First aid care for unconscious patients, the treatment of respiratory obstruction or failure, and the recognition and management of cardiac arrest is taught in a single two hour session. Over 20 000 people have been taught, up to 40 at a time in multiple groups of six to eight, by lay instructors usually supervised by ambulancemen trained to "paramedic" standards. Fifty four incidents have been reported to us in which techniques learnt in the classes have been implemented. Five patients recovered after first aid support but subsequently did not seek medical treatment. Of the 34 patients reviewed in hospital, at least 20 survived to be discharged. We believe that intervention may have been life saving in 16 instances. The benefit of cardiopulmonary resuscitation for victims who may have been asystolic is, however, difficult to quantify because the outcome without intervention cannot be predicted accurately. Community training in basic life support should be considered in association with ambulances equipped for resuscitation and hospital intensive care and cardiac care units as an integrated service for the victims of sudden circulatory or respiratory emergencies. The results achieved so far in Brighton and in other more advanced schemes, particularly in the United States of America, may encourage other health authorities to adopt similar programmes.
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O'Doherty M, Tayler DI, Quinn E, Vincent R, Chamberlain DA. Five hundred patients with myocardial infarction monitored within one hour of symptoms. Br Med J (Clin Res Ed) 1983; 286:1405-8. [PMID: 6404481 PMCID: PMC1547866 DOI: 10.1136/bmj.286.6375.1405] [Citation(s) in RCA: 96] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Of 2886 patients monitored during acute myocardial infarction, 500 were observed within one hour of the onset of symptoms. Half of the early admission group were admitted in response to emergency 999 calls and 435 of them travelled in resuscitation ambulances, where surveillance for arrhythmias was instituted. Pulmonary oedema occurred in 130 patients (26%), cardiogenic shock supervened in 60 (12%), and 115 (23%) died in hospital. Ventricular fibrillation was observed in 98 patients (20%). Forty two of them survived to be discharged, including 20 of the 24 with primary fibrillation which had occurred first in hospital. In only one case did primary ventricular fibrillation occur after the first 10 hours of onset of illness. Sinus bradycardia, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation were all observed more frequently in patients admitted within one hour after the onset of symptoms than in those admitted later. An element of selection is inevitable when early admission is encouraged by the existence of a resuscitation ambulance system; this will depend in part on the early recognition of risk and the geographical location of the attack. These factors may bias the group towards relatively high risk. Nevertheless, prompt admission after myocardial infarction should improve survival by permitting successful management both of ventricular fibrillation and of other arrhythmias which may influence short term and long term prognosis.
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Abstract
A sereopidemiologic survey was done to ascertain the level of immunity in a population of hospital employees after contact with patients with Legionnaires' disease. Two matched groups were compared: hospital staff in positions of contact with patients diagnosed with the disease (N1 = 215), and hospital staff not in a position of contact with patients diagnosed with Legionnaires' disease (N2 = 269). Antibody titer was measured by the hemagglutination technique. Subjects from N1 and N2 were surveyed for age, sex, race, smoking, patient care unit, air conditioning unit, occupation, symptoms, and patient contact. No significant correlation was found between titer distribution and any one of the first seven factors. The prevalence of antibody (greater than or equal to 128) was 9.3% and 3.7% (P less than 0.02) for the N1 and N2 groups. Also, 40% of employees with titers of 128 or above had had an unexplained febrile respiratory illness in the preceding year. This study suggests the possibility of person-to-person transmission in Legionnaires' disease.
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Campbell I, Quinn E, Martin FI. Experience in the treatment of diabetes at Port Moresby General Hospital. P N G Med J 1978; 21:343-6. [PMID: 293109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Dietary restriction of refined carbohydrate with regular meals and exercise, preventative foot care, and often daily inulin injections will reduce the mortality and morbidity from diabetes in Papua New Guinea. It is necessary to explain to both the diabetic and their family practical means of treatment including urine tests for glucose. Regular follow up is essential and the establishment of diabetic clinics in major centres would provide the best means of achieving this.
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del Busto R, Haas E, Madhaven T, Burch K, Cox F, Fisher E, Quinn E, Pohlod D. In vitro and clinical studies of cefatrizine, a new semisynthetic cephalosporin. Antimicrob Agents Chemother 1976; 9:397-405. [PMID: 1259399 PMCID: PMC429543 DOI: 10.1128/aac.9.3.397] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Cefatrizine, a new oral semisynthetic cephalosporin, was evaluated in vitro and in the treatment of 18 patients with acute urinary tract infection, pneumonia, and soft tissue infection. In vitro, it was more active than cephalexin for gram-positive and gram-negative bacteria. It was also more active than cephalothin, cefazolin, and cephapirin against most of the gram-negative bacteria but less active against the gram-positive bacteria. Of the patients treated with cefatrizine, only one failed to respond. This patient had pneumococcal conjunctivitis and hypogammaglobulinemia and neutropenia. The mean peak serum level after multiple 6-hourly doses of 500 mg was 6.2 mug/ml. The serum levels of cefatrizine necessary for inhibition of most susceptible organisms were well within the achievable range. The drug was well tolerated, and no renal, hepatic, or hematological toxicity was detected.
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Quinn E, Cox F, Burch K, Fisher E, Madhavan T. Antibiotic Prophylaxis — Yes or No? — Endocarditis. Chemotherapy 1976. [DOI: 10.1007/978-1-4613-4346-2_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Brandon FB, Cox F, Quinn E, Timm EA, McLean IW. Influenza immunization: clinical studies with ether-split subunit vaccines. Bull World Health Organ 1969; 41:629-37. [PMID: 5309487 PMCID: PMC2427697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Clinical studies of ether-split influenza antigen vaccines have been in progress for almost a decade. One series of such studies, completed before the Hong Kong virus appeared, compared identically constituted conventional and antigen vaccines for serological effectiveness in 1700 vaccinees from the staff of a metropolitan hospital. A series of 6 annual trials included both "old" subjects (vaccinated the previous year) and "new" subjects (no vaccination the previous year). The serological response to the type A2 component of the antigen vaccines was 3-4 times better than that to intact virus in both the old and new populations. The response to either vaccine by new subjects significantly exceeded the response by the old subjects. The type B component of both vaccines induced an equivalent response in both populations. Monovalent Hong Kong vaccines, both conventional and antigen, given just prior to the Hong Kong epidemic induced an anamnestic response in a geriatric group. No influenza-like disease was seen in this high-risk group during the epidemic.
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Brandon FB, Cox F, Lease GO, Timm EA, Quinn E, McLean IW. Respiratory Virus Vaccines. The Journal of Immunology 1967. [DOI: 10.4049/jimmunol.98.4.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Summary
The antibody responses of hospital staff volunteers to polyvalent influenza vaccines containing either intact virus or SPEE virus antigens were compared.
Significant increases in HI antibody against each virus strain in both vaccines were observed. Furthermore, postvaccination antibody titers against three of the four strains were significantly greater in the group receiving the SPEE antigens than were those in the group given intact virus.
Evidence that the SPEE antigens may be more efficient antibody stimulators than their intact counterparts is presented and discussed.
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Affiliation(s)
- F. B. Brandon
- Research Laboratories of Parke, Davis & Company , and the , Detroit, Michigan
- Division of Infectious Diseases, Henry Ford Hospital , and the , Detroit, Michigan
| | - F. Cox
- Research Laboratories of Parke, Davis & Company , and the , Detroit, Michigan
- Division of Infectious Diseases, Henry Ford Hospital , and the , Detroit, Michigan
| | - G. O. Lease
- Research Laboratories of Parke, Davis & Company , and the , Detroit, Michigan
- Division of Infectious Diseases, Henry Ford Hospital , and the , Detroit, Michigan
| | - E. A. Timm
- Research Laboratories of Parke, Davis & Company , and the , Detroit, Michigan
- Division of Infectious Diseases, Henry Ford Hospital , and the , Detroit, Michigan
| | - E. Quinn
- Research Laboratories of Parke, Davis & Company , and the , Detroit, Michigan
- Division of Infectious Diseases, Henry Ford Hospital , and the , Detroit, Michigan
| | - I. W. McLean
- Research Laboratories of Parke, Davis & Company , and the , Detroit, Michigan
- Division of Infectious Diseases, Henry Ford Hospital , and the , Detroit, Michigan
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Brandon FB, Cox F, Lease GO, Timm EA, Quinn E, McLean IW. Respiratory virus vaccines. 3. Some biological properties of Sephadex-purified ether-extracted influenza virus antigens. J Immunol 1967; 98:800-5. [PMID: 5336967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Thompson A, Wolfrom M, Quinn E. Additions and Corrections: Acid Reversion in Relation to Isomaltose as a Starch Hydrolytic Product. J Am Chem Soc 1957. [DOI: 10.1021/ja01581a600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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