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Biomedical subjects

M W Quinn

Publications and source records attributed to M W Quinn.

13 recordsLinked to original sources
PubMed1992

Effect of morphine and pancuronium on the stress response in ventilated preterm infants.

Ninety-five premature newborns who had hyaline membrane disease and were struggling against the ventilator were randomised to one of three treatment groups: morphine (group M), pancuronium (group P) or morphine with pancuronium (group M+P). The dose of morphine was 50 micrograms/kg per h but was increased to 100 micrograms/kg per h in group M infants if they continued to struggle. The dosage of pancuronium was 100 micrograms/kg given as required to inhibit spontaneous respiration. Plasma catecholamine levels were measured on entry and at 24 h. Blood pressure and ventilatory requirements were determined on entry and at 6 h. The clinical outcome of the infants was documented. Group M infants (n = 29) showed a significant reduction in noradrenaline levels (median change -2.2 nmols/l (range -47.2 to +7.2 nmols/l), although seven were withdrawn from this group because of failure to settle. Group P (n = 28) and group M+P (n = 38) showed no significant change in noradrenaline levels. Comparison between the groups showed that group M infants had a significant reduction in noradrenaline levels compared with group P. The immediate effects of treatment on blood pressure and ventilatory requirements were similar in the three groups. The clinical outcome did not differ for any of the measured parameters. When adequate sedation is achieved, morphine may reduce the stress of newborn intensive care.

Blood Pressure↗
PubMed1992

Cerebral arterial and venous flow-velocity measurements in post-haemorrhagic ventricular dilatation and hydrocephalus.

Simultaneous anterior cerebral artery (ACA) and internal cerebral vein (ICV) flow-velocities were measured in 18 babies with post-haemorrhagic ventricular dilatation (PHVD) and hydrocephalus (PHH). Compared with a control group matched for post-conceptional age, the resistance index of the ACA was increased. This was shown to occur at an early stage of PHVD in a longitudinal study of seven of the babies. There were no significant changes in ACA or ICV time-averaged velocities. Eight babies with PHH had ventricular taps on 18 occasions to relieve raised intracranial pressure. There was a significant decrease in the resistance index of the ACA, accompanied by an increase in the ACA time-averaged velocity, but no change in the ICV time-averaged velocity.

Blood Flow Velocity↗
PubMed1992

Intraventricular haemorrhage after aspiration of ventricular reservoirs.

A previously unrecognised complication of aspirating ventricular reservoirs is described. Four infants developed fresh bleeding into the cerebrospinal fluid after reservoir taps; ultrasound confirmed intraventricular blood clot in one case. The technique for aspirating the reservoir may have an important bearing on the incidence of this complication.

Cerebral Hemorrhage↗
PubMed1992

Middle cerebral artery pulsatility in children with blocked cerebrospinal fluid shunts.

The application of transcranial Doppler ultrasound to the diagnosis of blocked ventriculo-peritoneal shunts was studied in 63 children. Thirty two of these required shunt revision, whereas in 31 children symptoms resolved without surgery. The group of children requiring shunt revision had a significantly higher mean Gosling pulsatility index, than both the group of children whose symptoms resolved and a group of age-matched controls (p less than 0.001). Those with a raised pulsatility index were more likely to have higher intracranial pressure. There was no correlation between CT scan changes and the pulsatility index.

Adult↗
PubMed1991

The Doppler pulsatility index as a screening test for blocked ventriculo-peritoneal shunts.

Doppler ultrasound studies have demonstrated a raised Gosling pulsatility and Pourcelot resistance index in untreated hydrocephalus. The application of transcranial Doppler ultrasound to the diagnosis of blocked ventriculoperitoneal shunts was studied by comparing the Gosling pulsatility indices of 63 children with symptoms of shunt malfunction with a reference range derived from 248 asymptomatic shunted children. An abnormally raised pulsatility index predicted a blocked shunt with a sensitivity of 56% and a specificity of 97%. The pulsatility index correlated with intracranial pressure in patients with confirmed shunt blockage.

Adolescent↗
PubMed1990

Morbidity and outcome of shunted hydrocephalus.

Over an eighteen month period 50 children with hydrocephalus of different aetiologies were treated with a ventriculo-peritoneal shunt during the first year of life. The morbidity associated with their shunts and their outcome were reviewed after 10 years. During the 10 year follow-up period 82% required a shunt revision. The number of hospitalisations varied widely (range 0-13, median 3). 28% suffered from a shunt infection at some time during the 10 years. Shunt revisions and shunt infections had no significant effect on long-term outcome. 72% of the infants had a good outcome and the sub-group of infants with post-haemorrhagic hydrocephalus fared as well as the rest.

Cerebrospinal Fluid Shunts↗
PubMed1990

Impact of vessel distortion on transcranial Doppler velocity measurements: correlation with magnetic resonance imaging.

Because transcranial Doppler ultrasound is a blind procedure, it is not possible to routinely correct for insonation angle errors, which are presumed to be small. In anatomically normal brains this is a valid assumption; however, in some patients with distorted vascular anatomy (as in hydrocephalus) a small insonation angle cannot be assumed, and measurements of flow velocity may be misleadingly low. The orientation of the middle cerebral arteries was studied on magnetic resonance images of 17 control patients and three patients with hydrocephalus, and estimates of insonation angle errors in velocity measurements were made. When asymmetrical vessel distortion is present, relative flow to each hemisphere may not be accurately reflected in the measured velocities. Under these circumstances, the resistivity index may be a more reliable hemodynamic parameter.

Blood Flow Velocity↗
PubMed1988

ABO incompatibility.

Explore the source record for details and available documents.

ABO Blood-Group System↗
PubMed1988

Does ABO incompatibility matter?

The incidence and severity (peak serum bilirubin concentration) of clinically detectable jaundice was determined retrospectively in 110 elution positive cases of ABO incompatibility. Neither the incidence nor the severity of jaundice in the study group differed significantly from a control group. In the individual case Coombs positivity and/or a strongly positive elution test may be a helpful predictor of jaundice occurring but not of its severity.

ABO Blood-Group System↗