18 results on '"Quinn NJ"'
Search Results
2. Reproductive Ecology of Two Faviid Corals (Coelenterata: Scleractinia)
- Author
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Kojis, BL, primary and Quinn, NJ, additional
- Published
- 1982
- Full Text
- View/download PDF
Catalog
3. Scoping review of drug dosing recommendations in sustained low-efficiency dialysis.
- Author
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Nelson NR, Quinn NJ, Bills S, Dellabella A, Gregar SE, Lear A, Marsolek L, Mounce C, and Tobin M
- Subjects
- Humans, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents pharmacokinetics, Antifungal Agents administration & dosage, Antifungal Agents pharmacokinetics, Levetiracetam administration & dosage, Levetiracetam pharmacokinetics, Dose-Response Relationship, Drug, Renal Dialysis methods
- Abstract
The objective of this scoping review was to answer the question, "What has been published describing drug dosing in sustained low-efficiency dialysis (SLED)?" PubMed, Embase, and Scopus were searched on November 18, 2022. Methodology followed the Arksey and O'Malley framework for scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines. Two investigators independently screened abstracts and full-texts of citations identified related to drug dosing and SLED. Exclusion criteria included case reports, conference abstracts, pediatrics, treatment dialysis, and non-human subjects. A standardized data extraction sheet was used to collate and summarize data. The quality of evidence was evaluated by two investigators using the Mixed Methods Appraisal Tool. A total of 230 citations were identified for screening. Of these, 29 studies met criteria for inclusion after full-text review. Four drug groups including beta-lactam antibiotics, non-beta-lactam antibiotics, antifungals, and levetiracetam were identified. Dialysate rates, dialysis durations, and medication doses used varied widely across studies. Outcomes and pharmacokinetic parameters that were assessed were also heterogenous. Drug dosing in SLED is challenging and there is minimal evidence available to guide appropriate dosing. Larger studies are needed to more accurately determine how to appropriately dose medications in SLED. Therapeutic drug monitoring should be used in all patients on SLED when available., (© 2024 Pharmacotherapy Publications, Inc.) more...
- Published
- 2024
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4. Triglyceride Concentrations and Their Relationship to Sedation Choice and Outcomes in Mechanically Ventilated Patients Receiving Propofol.
- Author
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Pancholi P, Wu J, Lessen S, Brogan J, Quinn NJ, Gong MN, and Moskowitz A
- Subjects
- Adult, Humans, Midazolam adverse effects, Respiration, Artificial, Cohort Studies, Hypnotics and Sedatives adverse effects, Intensive Care Units, Propofol adverse effects, Dexmedetomidine adverse effects, Ketamine adverse effects, Hypertriglyceridemia chemically induced, Hypertriglyceridemia epidemiology, Pancreatitis chemically induced, Pancreatitis epidemiology
- Abstract
Rationale: Propofol is a first-line sedative agent in the intensive care unit (ICU) but may be associated with hypertriglyceridemia and pancreatitis. To date, the relationship between propofol-induced hypertriglyceridemia and pancreatitis, as well as clinician responses to propofol-induced hypertriglyceridemia, have not been comprehensively studied. Objectives: To assess the incidence of hypertriglyceridemia and pancreatitis in patients receiving continuous propofol infusions in the ICU and to describe the association between hypertriglyceridemia and the use of nonpropofol continuous sedative infusions. Methods: This was a retrospective observational cohort study conducted at three urban academic hospitals within a single health system. Findings were additionally validated using the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database containing data from a separate tertiary care hospital. Mechanically ventilated adult patients who received a continuous propofol infusion between 2016 and 2021 were included. The primary exposure was serum triglyceride concentration, and hypertriglyceridemia was defined as a triglyceride concentration greater than 400 mg/dl. Outcomes included new-onset pancreatitis as well as receipt of midazolam, dexmedetomidine, or ketamine after the triglyceride measurement. The incidence of pancreatitis was compared between groups using a Fisher's Exact test. Multivariable logistic regression was used to assess the association between dichotomized triglyceride concentration and alternative sedative use. Results: In the primary cohort of 7,037 patients, 1,724 (24.5%) had one or more triglyceride concentration measured. Of these, 1,365 (79.2%) had a maximum concentration of less than 400 mg/dl, and 359 (20.8%) had a maximum concentration of greater than 400 mg/dl. Compared with patients with low triglyceride concentrations, patients with high triglyceride concentrations were more likely to receive a continuous infusion of midazolam (37.0% vs. 16.4%; adjusted odds ratio [aOR], 3.1; 95% confidence interval [CI], 2.2-4.4; P < 0.01), ketamine (22.8% vs. 6.9%; aOR, 3.5; 95% CI, 2.3-5.3; P < 0.01), and dexmedetomidine (57.7% vs. 46.6%; aOR, 1.5; 95% CI, 1.1-2.0; P < 0.01). Rates of midazolam infusion increased as triglyceride concentrations exceeded 500 mg/dl. Forty-four (0.6%) patients developed pancreatitis after propofol initiation, of which 4 (9.1%) were considered related to propofol-associated hypertriglyceridemia. Findings were similar in the MIMIC-IV cohort. Conclusions: Propofol-associated hypertriglyceridemia is relatively common in mechanically ventilated ICU patients who have triglycerides measured. Pancreatitis related to propofol-associated hypertriglyceridemia is rare. Patients who develop hypertriglyceridemia while receiving propofol are more likely to receive continuous infusions of other sedatives. more...
- Published
- 2023
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5. Safety and Efficacy Analysis of Apixaban Compared to Heparins in Hospitalized Non-Critically Ill COVID-19 Patients.
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Appiah D, Quinn NJ, Messing EG, and Veltri KT
- Abstract
Purpose: Heparin-based regimens are recommended for anticoagulation in hospitalized patients with COVID-19 though a study reported similar mortality with apixaban in critically ill hospitalized COVID-19 patients. Our pilot study sought to determine the differences in all-cause mortality, venous thromboembolism (VTE), and bleeding events between apixaban and therapeutic heparin-based regimens in hospitalized non-critically ill COVID-19 patients. Methods: We conducted a retrospective analysis of non-critically ill COVID-19 patients aged ≥ 18 years admitted to 3 campuses of Montefiore Medical Center during the first (March 2020 to May 2020) and second (January 2021 to February 2021) COVID-19 surges, who received within 48 hours of admission and continued for ≥72 hours a therapeutic dose of low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), or any apixaban dose for VTE prophylaxis. Outcomes data analyzed included mortality, suspected or imaging-confirmed VTE, and bleeding using a defined criteria. Results: Overall, 162 patients met eligibility for analysis. Baseline characteristics were similar between the 2 groups except liver and renal functions. Mortality occurred in 10 (13.3%) patients on apixaban and 23 (26.4%) patients on a heparin-based regimen ( P = .059). Confirmed VTE events were not different between the groups (8% vs 13.8%, P = .359), but higher incidence of bleeding occurred in heparin-based group (4% vs 52.9%, P < .001). Conclusion: There were no differences in mortality or confirmed VTE between apixaban and heparin-based regimens except for more bleeding events with the heparins. This study highlights the utility of apixaban in COVID-19., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.) more...
- Published
- 2022
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- View/download PDF
6. Determinants of Vancomycin Trough Concentration in Patients Receiving Continuous Veno-Venous Hemodialysis.
- Author
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Quinn NJ, Sacha GL, Wanek MR, Yerke J, Srinivas P, and Hohlfelder B
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- Adult, Anti-Bacterial Agents, Critical Illness therapy, Dialysis Solutions, Humans, Retrospective Studies, Continuous Renal Replacement Therapy, Vancomycin
- Abstract
Background: Vancomycin pharmacokinetics are altered in the critically ill and are further distorted by renal replacement therapy. Limited literature is available evaluating vancomycin dosing in continuous veno-venous hemodialysis (CVVHD)., Objective: The goal of this analysis was to identify factors that affect vancomycin trough concentration in patients on CVVHD and to determine an appropriate dosing strategy., Methods: This was a single-center, retrospective cohort study of adult inpatients admitted to the Cleveland Clinic from May 2016-December 2017. Patients in the intensive care unit who received ≥ 2 doses of vancomycin during CVVHD were included. Patients with interruptions of CVVHD inappropriately timed troughs, a change in dialysate rate, and those who received different vancomycin dosages were excluded. Multivariable linear regression including age, sex, weight, Sequential Organ Failure Assessment score, albumin, 24-hour urine output (UOP), dialysate rate, filter type, and vancomycin dose was run to determine predictors of vancomycin concentration., Results: A total of 160 patients were included. The median vancomycin dose was 12.6 mg/kg with a trough of 24.6 mcg/mL. Weight, 24-hour UOP, vancomycin dose (mg/kg), and dialysate rate (mL/kg/h) were all determined to be independent predictors of vancomycin trough level. Patients who received <10 mg/kg doses of vancomycin (N=18) achieved a median trough of 21.5 mcg/mL, with 83% being therapuetic. In patients who received >10 mg/kg (N=142), the median trough was 25.5 mcg/mL, with 47% being therapeutic., Conclusion and Relevance: Vancomycin dose, dialysate rate, UOP, and weight are independently associated with vancomycin trough concentration. In CVVHD patients, vancomycin dosed at 10 mg/kg every 24 hours may be an appropriate recommendation. more...
- Published
- 2022
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7. CE: Using Smart IV Infusion Pumps Outside of Patient Rooms.
- Author
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Messing EG, Abraham RS, Quinn NJ, and Duthie EA
- Subjects
- COVID-19 therapy, Humans, Pandemics, Personal Protective Equipment supply & distribution, SARS-CoV-2, COVID-19 transmission, Infusion Pumps, Patient Isolation methods, Patients' Rooms organization & administration
- Abstract
Abstract: The COVID-19 pandemic has created unique challenges for health care workers, who have demonstrated dedication, collaboration, and innovation in response. In this article, the authors describe an important nursing innovation they employed at Montefiore Medical Center in the Bronx, New York, during the spring 2020 COVID-19 surge: the relocation of smart IV infusion pumps outside of patient rooms. The goals of this innovation were to improve delivery of care, conserve personal protective equipment, limit the spread of the virus, and protect staff from exposure. The authors discuss the initial concerns that arose regarding the safety and efficacy of this practice; the research they conducted with other colleagues in nursing, pharmacy, infection control, and patient safety in the face of scant clinical literature relevant to the difficult circumstances the pandemic created; and the strategies they ultimately employed to ensure that this practice maintained safety and efficacy., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.) more...
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- 2022
- Full Text
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8. Prescribing Practices of Valproic Acid for Agitation and Delirium in the Intensive Care Unit.
- Author
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Quinn NJ, Hohlfelder B, Wanek MR, Duggal A, and Torbic H
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- Aged, Anticonvulsants pharmacology, Cohort Studies, Female, Humans, Incidence, Male, Middle Aged, Retrospective Studies, Valproic Acid pharmacology, Anticonvulsants therapeutic use, Antipsychotic Agents therapeutic use, Intensive Care Units standards, Psychomotor Agitation drug therapy, Valproic Acid therapeutic use
- Abstract
Background: Analgesics, sedatives, and antipsychotics are commonly prescribed for agitation and delirium in the intensive care unit (ICU), but their use is limited by adverse effects and lack of efficacy. Valproic acid is an alternative treatment option., Objective: The primary objective of this study was to describe valproic acid prescribing in our institution's ICUs when used for agitation or delirium. Measures of effectiveness and safety were also assessed., Methods: This was a single-center, retrospective, institutional review board-approved cohort study of adult inpatients admitted to the ICU between January 2018 and August 2018. Patients who received valproic acid for the treatment of agitation or delirium for ≥24 hours were included. Prescribing practices were evaluated for dose, frequency, and route of administration. Effectiveness was assessed via agitation and delirium assessment tools and quantity of adjunctive agents used., Results: A total of 80 patients were included, with 35 receiving valproic acid alone and 45 in conjunction with antipsychotics. The most common valproic acid regimen was 250 mg orally 3 times daily. Delirium resolution occurred in 55% of patients: 24 in the valproic acid monotherapy group and 20 in the valproic acid plus antipsychotic group (69% vs 44%; P = 0.03). The incidence of delirium decreased from valproic acid day 0 to day 3 (93% vs 68%; P < 0.01), with no change in agitation (64% vs 63%; P = 0.28)., Conclusion and Relevance: Valproic acid is frequently prescribed in agitated, delirious patients at our institution and may have a role in the management of ICU delirium. more...
- Published
- 2021
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9. Practicing during a pandemic: The role of a new pharmacy practitioner.
- Author
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Messing EG, Quinn NJ, Shah DD, Veltri K, and Chirico J
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- Humans, Informatics, Pharmaceutical Services, Professional Practice, COVID-19, Pandemics, Pharmacists, Pharmacy Service, Hospital organization & administration
- Published
- 2020
- Full Text
- View/download PDF
10. Clinical Pharmacists: An Invaluable Part of the Coronavirus Disease 2019 Frontline Response.
- Author
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Ferguson NC, Quinn NJ, Khalique S, Sinnett M, Eisen L, and Goriacko P
- Abstract
Although coronavirus disease 2019 was first identified in December 2019, it rapidly spread and became a global pandemic. The number of patients infected with the novel coronavirus (severe acute respiratory syndrome coronavirus 2) rose rapidly in New York State, placing great stress on healthcare systems. The traditional roles and practices of healthcare providers were dramatically redefined to meet the demand to care for the large number of ill patients. While literature reports on the experiences of many frontline staff, there is a scarcity of reports on the role of clinical pharmacists during this crisis. We report the role of critical care clinical pharmacists at a large academic medical center in New York City during this pandemic. Effective crisis management required clinical pharmacists to employ a wide array of skills and knowledge. Areas included clinical expertise, education, data analysis, health informatics infrastructure, and inventory management in times of surging medication use and manufacturer shortages. Clinical pharmacists fulfilled an essential service during the coronavirus pandemic by working to ensure the best possible outcomes for the patients they served on the frontline., Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.) more...
- Published
- 2020
- Full Text
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11. Recording problems and diagnoses in clinical care: developing guidance for healthcare professionals and system designers.
- Author
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Shah AD, Quinn NJ, Chaudhry A, Sullivan R, Costello J, O'Riordan D, Hoogewerf J, Orton M, Foley L, Feger H, and Williams JG
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- Health Personnel education, Humans, Patient Preference, Consensus, Data Collection standards, Guidelines as Topic standards, Medical Records Systems, Computerized standards, Referral and Consultation
- Abstract
Background: Accurate recording of problems and diagnoses in health records is key to safe and effective patient care, yet it is often done poorly. Electronic health record systems vary in their functionality and ease of use, and are not optimally designed for easy recording and sharing of clinical information. There is a lack of professional consensus and guidance on how problems and diagnoses should be recorded., Methods: The Professional Record Standards Body commissioned work led by the Royal College of Physicians Health Informatics Unit to carry out a literature review, draft guidance, carry out an online consultation and round table discussion, and produce a report including recommendations for systems. A patient workshop was held to explore patient preferences for mechanisms for sharing diagnosis information between primary and secondary care., Results: Consensus was reached among medical specialties on key elements of diagnosis recording, and draft guidance was produced ready for piloting in a variety of care settings. Patients were keen for better ways for diagnosis information to be shared., Discussion: Improving the recording of diagnoses and problems will require a major effort of which the new guidance is only a part. The guidance needs to be embedded in training, and clinical systems need to have improved, standardised functionality. Front-line clinicians, specialist societies, clinical informaticians and patients need to be engaged in developing information models for diagnoses to support care and research, accessible via user-friendly interfaces., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) more...
- Published
- 2019
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12. Effectiveness of oral antibiotics for definitive therapy of non-Staphylococcal Gram-positive bacterial bloodstream infections.
- Author
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Quinn NJ, Sebaaly JC, Patel BA, Weinrib DA, Anderson WE, and Roshdy DG
- Abstract
Background: Data on the effectiveness of definitive oral (PO) antibiotics for BSIs in preparation for discharge from hospital are lacking, particularly for Gram-positive bacterial BSIs (GP-BSI). The objective of this study was to determine rates of treatment failure based on bioavailability of PO antimicrobial agents used for GP-BSI., Methods: This was a single-center, retrospective cohort study of adult inpatients admitted to an academic medical center over a three-year period. Patients with a non-staphylococcal GP-BSI who received intravenous antibiotics and were then switched to PO antibiotics for at least a third of their treatment course were included. The cohort was stratified into high (⩾90%) and low (<90%) bioavailability groups. The primary endpoint was the proportion of patients experiencing clinical failure in each group. Secondary endpoints included clinical failure stratified by antibiotic group, bactericidal versus bacteriostatic PO agents, and organism., Results: A total of 103 patients met criteria for inclusion, which failed to reach the a priori power calculation. Of the patients included, 26 received high bioavailability agents and 77 received low bioavailability agents. Infections originated largely from a pulmonary source (30%) and were caused primarily by streptococcal species (75%). Treatment failure rates were 19.2% in the high bioavailability group and 23.4% in the low bioavailability group ( p = 0.66). Clinical failure stratified by subgroups also did not yield statistically significant differences., Conclusions: Clinical failure rates were similar among patients definitively treated with high or low bioavailability agents for GP-BSI, though the study was underpowered to detect such a difference., Competing Interests: Conflict of interest statement: The authors declare that there is no conflict of interest. more...
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- 2019
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13. Patterns of sexual recruitment of acroporid coral populations on the west fore reef at Discovery Bay, Jamaica.
- Author
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Quinn NJ and Kojis BL
- Subjects
- Animals, Biodiversity, Culture Media, Environmental Monitoring, Jamaica, Population Density, Population Dynamics, Reproduction physiology, Anthozoa physiology, Ecosystem, Seasons, Sexual Behavior, Animal physiology
- Abstract
Coral recruitment was examined on terracotta tiles deployed for four six-month periods between March 2001 and April 2003 on the West Fore Reef at Discovery Bay, Jamaica. During each sampling period, four tiles were deployed on each of two arrays at six depths ranging from 3 m to 33 m. Only three Acropora spat recruited to the tiles over the sampling period. The Acropora spat recruited during only one of the four six-month sampling periods and at only one depth, 3m. That represents a density of 8 spat m(-2) at 3 m depth for one six-month sampling period. Acropora recruitment represented <1 % of the total spat recruiting to the tiles deployed at 3 m during the four sampling periods. Density of acroporids on the West Fore Reef is low. Only one Acropora colony (an A. palmata) was recorded during Point-Quarter surveys of coral cover and density at depths of 3 m, 9 m, 14 m and 19 m. Considering the paucity of acroporid colonies and the infrequent settlement of acroporid spat on the West Fore Reef, it is unlikely that the historic abundance of A. palmata and A. cervicornis will return soon. more...
- Published
- 2005
14. Variation in subsurface seawater temperature off Discovery Bay, Jamaica and the U.S. Virgin Islands.
- Author
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Quinn NJ and Kojis BL
- Subjects
- Jamaica, Seasons, United States Virgin Islands, Environmental Monitoring, Seawater, Temperature
- Abstract
Long-term, high accuracy seawater temperature data sets are essential in studies assessing environmental changes that may alter coral reef communities. Located at the approximately the same latitude, the subsurface seawater temperature (S3T) off Discovery Bay, Jamaica (DBJ) and the U.S. Virgin Islands (USVI) had the same overall mean temperature. The USVI S3T during the winter months is approximately 0.5 degrees C warmer than DBJ, while May - July at DBJ is approximately 1 degrees C warmer than USVI S3T. With the passing of tropical storms in 1995 and 1997 in the USVI S3T dropped as much as 1.5 degrees C within a 20 hr period and did not revert to the previous temperature during that calendar year. Mean monthly S3T during 2000 and 2001 in the USVI was > 0.5 degrees C warmer than during similar periods in the early 1990s. Mean monthly S3T during 1999-2002 at DBJ was 0.27 degrees C cooler than during 1994-1995. more...
- Published
- 2003
15. Recent settlement trends in Panulirus argius (Decapoda: Palinuridae) pueruli around St. Thomas, U.S. Virgin Islands.
- Author
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Kojis BL, Quinn NJ, and Caseau SM
- Subjects
- Animals, Population Density, Population Dynamics, Seasons, United States Virgin Islands, Fisheries, Palinuridae
- Abstract
Puerulus settlement of the western Atlantic spiny lobster, Panulirus argus, was monitored using modified Witham collectors from December 1996 to March 1998 at seven sites around St. Thomas, U.S. Virgin Islands. A total of 605 pueruli were collected from 553 samples for a catch per unit effort (CPUE) for all sites of 1.09 pueruli. The greatest settlement occurred on sites within a recently declared marine reserve, which had an overall CPUE of 1.77 pueruli. Settlement in non-reserve sites was much lower with an overall CPUE of 0.31 pueruli. Pueruli recruitment declined 67% at inshore sites and 53% at offshore sites between July 1992 - April 1994 and February 1997 - March 1998. Also, only 10% of months sampled in 1997-98 had a CPUE > 0.5 compared to 55% in a previous study in 1992 - 1993. Despite the decline in pueruli CPUE in 1997-98 compared to 1992-94, the commercial lobster catch in the 2000-01 fishing season, and by inference the adult lobster population (legal lobster size in the US Virgin Islands is > or = 3.5 cm carapace length), remained stable. more...
- Published
- 2003
16. Operation Stork: promoting infant-maternal bonding with adopting parents.
- Author
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Quinn NJ Jr, Carlin E, Garrity TM, and Himsworth JJ
- Subjects
- Child Welfare, Hospital Administration, Hospitals, Community, Humans, Infant, Newborn, Nurseries, Hospital, Adoption, Mother-Child Relations
- Published
- 1978
- Full Text
- View/download PDF
17. Toe tourniquet syndrome.
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Quinn NJ Jr
- Subjects
- Cellulitis etiology, Constriction etiology, Edema etiology, Humans, Infant, Reflex, Clothing adverse effects, Foot Diseases etiology, Toes, Tourniquets adverse effects
- Published
- 1971
18. Diagnostic catheter examinations of the newborn. Should these be done routinely?
- Author
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Quinn NJ Jr, Levkoff AH, Illingworth RS, Cochran WD, Oliver TK Jr, and Nelson NM
- Subjects
- Anus, Imperforate diagnosis, Congenital Abnormalities diagnosis, Duodenal Obstruction diagnosis, Female, Humans, Infant, Newborn, Intestinal Atresia diagnosis, Male, Methods, Nasopharynx abnormalities, Pancreas abnormalities, Physical Examination, Retrospective Studies, Tracheoesophageal Fistula diagnosis, Digestive System Abnormalities, Gastrointestinal Hemorrhage etiology, Intubation, Gastrointestinal adverse effects, Respiratory System Abnormalities
- Published
- 1971
- Full Text
- View/download PDF
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