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Biomedical subjects

K Quinlan

Publications and source records attributed to K Quinlan.

8 recordsLinked to original sources
PubMed2006

Child passenger safety for inner-city Latinos: new approaches from the community.

OBJECTIVE: Motor vehicle crashes injuries, the leading cause of death for Latino children in the United States, can be reduced by the correct use of child safety seats. This study evaluated the ability of a community health worker education program to improve proper child safety seat usage in urban low income Latino families. METHODS: At a series of check events, proper child safety seat usage in families who had received an education intervention was compared with similar families who had not. The education intervention, provided by Latino community health workers trained as child passenger safety technicians, used videos and an office demonstrator. Members of the target community initiated the study and participated in its subsequent design and implementation. RESULTS: The families that participated in the study were primarily Mexican with low income, education, and acculturation levels. Forty six rear facing and 44 forward facing child safety seats were checked. Families exposed to the intervention were more likely to have their child's seat within the manufacturer's recommended weight/height range, their child facing the correct direction, the harness straps positioned properly, to have not been in a crash, the harness straps snug, the harness retainer clip used correctly, the seat belt routed correctly, and the seat belt locked. CONCLUSIONS: Exposure to an educational intervention provided by community health workers trained as child passenger safety technicians was associated with child safety seats being used more properly than seats of families not exposed to the intervention in an urban low income Latino community.

Adolescent↗
PubMed2004

Modelling thirty-day mortality in the Acute Respiratory Distress Syndrome (ARDS) in an adult ICU.

Variables predicting thirty-day outcome from Acute Respiratory Distress Syndrome (ARDS) were analysed using Cox regression structured for time-varying covariates. Over a three-year period, 1996-1998, consecutive patients with ARDS (bilateral chest X-ray opacities, PaO2/FiO2 ratio of <200 and an acute precipitating event) were identified using a prospective computerized data base in a university teaching hospital ICU. The cohort, 106 mechanically ventilated patients, was of mean (SD) age 63.5 (15.5) years and 37% were female. Primary lung injury occurred in 45% and 24% were postoperative. ICU-admission day APACHE II score was 25 (8); ARDS onset time from ICU admission was 1 day (median: range 0-16) and 30 day mortality was 41% (95% CI: 33%-51%). At ARDS onset, PaO2/FiO2 ratio was 92 (31), 81% had four-quadrant chest X-ray opacification and lung injury score was 2.75 (0.45). Average mechanical ventilator tidal volume was 10.3 ml/predicted kg weight. Cox model mortality predictors (hazard ratio, 95% CI) were: APACHE II score, 1.15 (1.09-1.21); ARDS lag time (days), 0.72 (0.58-0.89); direct versus indirect injury, 2.89 (1.45-5.76); PaO2/FiO2 ratio, 0.98 (0.97-0.99); operative versus non-operative category, 0.24 (0.09-0.63). Time-varying effects were evident for PaO2/FiO2 ratio, operative versus non-operative category and ventilator tidal volume assessed as a categorical predictor with a cut-point of 8 ml/kg predicted weight (mean tidal volumes, 7.1 (1.9) vs 10.7 (1.6) ml/kg predicted weight). Thirty-day survival was improved for patients ventilated with lower tidal volumes. Survival predictors in ARDS were multifactorial and related to patient-injury-time interaction and level of mechanical ventilator tidal volume.

APACHE↗
PubMed2001

The effect of repeated exposure to particulate air pollution (PM10) on the bone marrow.

Studies have shown that exposure to ambient particulate matter is related to an increased cardiopulmonary morbidity and mortality. The present study was designed to measure the effect of repeated exposure to urban air particles (PM10) on the rate of production and release of polymorphonuclear leukocytes (PMN) from the bone marrow into the peripheral blood. Rabbits exposed to PM10 (5 mg) twice a week for 3 wk, were given a bolus of 5'-bromo-2'-deoxyuridine (BrdU) to label dividing cells in the marrow that allows us to calculate the transit time of PMN in the bone marrow mitotic and postmitotic pools. The PM10 exposure (n = 8) causes a persistent increase in circulating band cells (p < 0.05) and a shortening of the transit time of PMN through the postmitotic pool in the marrow (64.4 +/- 2.2 h to 56.3 +/- 2.2 h, p < 0.05) if compared with vehicle-exposed control subjects (n = 6). PM10 exposure increases the bone marrow pool of PMN particularly the mitotic pool of PMN (p < 0.05). The PM10 were distributed diffusely in the lung and caused a mild mononuclear inflammation. The percentage of alveolar macrophages containing PM10 correlated significantly with the bone marrow PMN pool size (total pool r2 = 0.56, p < 0.012, mitotic pool r2 = 0.61, p < 0.007) and the transit time of PMN through the postmitotic pool (r2 = -0.42, p < 0.043). We conclude that repeated exposure to PM10 stimulates the bone marrow to increase the production of PMN in the marrow and accelerate the release of more immature PMN into the circulation. The magnitude of these changes was related to the amount of particles phagocytosed by alveolar macrophages.

Air Pollution↗
PubMed1993

Stability of red cell antigens and plasma coagulation factors stored in a non-diethylhexyl phthalate-plasticized container.

Red cell antigen stability studies were performed to evaluate whether the storage of red cells in plastic segments made up of a new non-di-2(ethylhexyl)phthalate (DEHP)-plasticized material resulted in poststorage antigenic reactivity different from that seen in segments made from DEHP-containing plastic. Serial 1-in-2 dilutions of commercially available antisera were prepared and tested by using stored red cells obtained from segments on Days 0, 28, 42, and, in some instances, 49. Antigenic determinants tested included A, B, D, c, K, Le(a), Fya, Jka, M, and P1. To minimize variability, the same reagent lots were used throughout each study, and the same technologists performed the assays in each laboratory. No significant differences in titration scores were seen when cells stored in segments made of the test plastic were compared with cells obtained from the same donor and stored for the same length of time in segments made of control plastic. In addition, plasma coagulation factor stability was studied in fresh-frozen plasma and cryoprecipitate stored for up to 1 year in the non-DEHP-plasticized plastic containers. No significant differences were seen in prothrombin time, activated partial thromboplastin time, fibrinogen content, or factor V, VII, VIII, IX, or X activity as compared with plasma stored for equal periods of time in control plastic containers. It is concluded that the test plastic does not adversely affect red cell antigenic reactivity or plasma coagulation factor stability and that it is suitable for use in clinical transfusion practice.

Blood Coagulation Factors↗