Use of, and outputs from, an assault patient questionnaire within accident and emergency departments on Merseyside.

OBJECTIVES: To describe the implementation, use of, and outputs from an assault patient questionnaire (APQ) introduced in accident and emergency (A&E) departments to determine Crime & Disorder and Community Safety priorities on Merseyside, a metropolitan county in north west England, UK. METHODS: Why and how the APQ was implemented, data collected, and information obtained. The subsequent incorporation of the APQ into the Torex Patient Administration System (PAS) at the Royal Liverpool University Hospital A&E department and its routine completion by trained reception staff. RESULTS: Analysis is based upon anonymised data-for example, patient ID and date of birth information is suppressed. A summary of "baseline" information obtained from the data collected is provided. CONCLUSIONS: It is possible for the APQ to be implemented at no extra cost in a large A&E department in an acute general teaching hospital. Valuable intelligence can be obtained for Crime & Disorder Act and Community Safety processes. The APQ forms part of a medium to long term strategy to prevent and reduce violent assaults in the community that subsequently require treatment in an A&E department. Such incidents include assaults both inside and outside licensed premises, attacks by strangers on the street, and domestic violence. Emphasis is also placed upon the feedback of results to staff in A&E departments.

Novel antimicrobial peptides derived from human immunodeficiency virus type 1 and other lentivirus transmembrane proteins.

We have previously described a conserved set of peptides derived from lentiviral envelope transmembrane proteins that are similar to the natural antimicrobial peptides cecropins and magainins in overall structure but bear no sequence homology to them or other members of their class. We describe here an evaluation of the antimicrobial properties of these virally derived peptides, designated lentivirus lytic peptides (LLPs). The results of this study demonstrate that they are potent and selective antibacterial peptides: the prototype sequence, LLP1, is bactericidal to both gram-positive and gram-negative organisms at micromolar concentrations in 10 mM phosphate buffer. Furthermore, LLP1 kills bacteria quite rapidly, causing a 1,000-fold reduction in viable organisms within 50 s. Peptides corresponding to sequences from three lentivirus envelope proteins were synthesized and characterized. Several of these peptides are selective, killing bacteria at concentrations 50- to 100-fold lower than those required to lyse erythrocytes. Development of antimicrobial agents based on these peptides may lead to improved therapeutics for the management of a variety of infectious diseases.

Ultrasonographic adrenal gland measurements in dogs without evidence of adrenal disease.

The purpose of this retrospective study was to determine measurements of adrenal glands from longitudinal sonograms, in a large population of dogs and to correlate these measurements to age, sex and descriptors of body size. Dogs were selected from the clinic population presented for routine abdominal ultrasonography between September, 1991 and March, 1994. Dogs with elevated serum cholesterol or alkaline phosphatase levels, polyuria/polydipsia, and/or clinical diagnoses of adrenal pathology were excluded. Dogs with ultrasound-documented abnormalities (mass lesions, abnormal architecture) of either adrenal were not considered. Age, sex, weight and breed were recorded, and the body surface area of each dog was calculated. Adrenal length and caudal polar width were determined from longitudinal, two-dimensional ultrasound images. Adrenal measurements were compared with body size measurements and age using least squares linear regression analysis and the correlation coefficient (r) and coefficient of determination (r2) calculated. One hundred and ninety three dogs were included in the study, with a weight and body surface area range of 1.8-72 kg and 0.2-1.8 m2, respectively. The left adrenal gland (n = 182) length range was from 10.7 to 50.2 mm, and the range of the caudal polar widths was 1.9 to 12.4 mm. Right adrenal gland (n = 85) length range was from 10 to 39.3 mm, and the range of the caudal polar widths was from 3.1 to 12 mm. In dogs where both adrenal gland lengths were measured (n = 74), the right adrenal gland length was less than that of the left in 46 dogs, equal to the left in one dog, and greater than the length of the left in 27 dogs. The strongest linear association was noted between the left adrenal gland length and body weight (kg, r = 0.71, p < 0.0001) or body surface area (m2, r = 0.71, p < 0.0001). Similar significant association was noted between the right adrenal gland length and body weight (kg, r = 0.69, p < 0.0001). A significant positive association was also noted between age and left adrenal gland length, (r = 0.25, p = 0.009). The summation of all four adrenal measurement values (left length and width, right length and width) did slightly improve the correlation (r = 0.74, p < 0.0001) when compared with body weight (kg). There was not a significant difference in the adrenal measurements with regard to sex. With regard to the correlation coefficient values, there was no advantage noted to calculating the body surface area from body weight. The causes for the low degrees of the correlation between adrenal size and the variables investigated in this study are unknown; measurement error, effects of non-adrenal illness on adrenal size, and a non-linear or complex linear relationship between adrenal gland size (as measured by longitudinal parameters) and descriptors of body size are among possible explanations.

Intra-abdominal hemorrhage associated with a granulosa-thecal cell neoplasm in a mare.

A 9-year-old American Saddlebred mare was referred because of abdominal distention and signs of abdominal pain. Copious peritoneal fluid obtained by abdominocentesis appeared to be frank blood. Rectal and ultrasonographic evaluation of the abdomen revealed a large mass at the distal tip of the right uterine horn. The mare was euthanatized and necropsied and the mass was determined to be a granulosa-thecal cell neoplasm. The most common clinical sign of granulosa-thecal cell neoplasm is infertility or abnormal sexual behavior. Hemoperitoneum is infrequently associated with neoplasms in horses.

The effects of fixation of the ulna to the radius in young foals.

The effects of radioulnar fixation were studied in 21 Quarter horse foals by applying a bone plate to the caudal aspect of the proximal part of the ulna, with screws engaging both the radius and the ulna. The plates were applied at 1 month of age in six foals (group I), 5 months of age in six foals (group II), and 7 months of age in three foals (group III). Six foals underwent sham operations at 1 month of age to serve as controls (group IV). Ulnar dysplasia and elbow subluxation developed in all treated foals. The magnitude of ulnar dysplasia was inversely related to the patient's age at fixation and was accompanied by degenerative joint disease and lameness in foals undergoing fixation at 1 and 5 months of age. Removal of the fixation appliances 16 weeks after implantation in three foals from each of groups I and II failed to reverse the degree of ulnar dysplasia. Although foals undergoing fixation at 7 months of age (group III) were not lame, radiographic evidence of subluxation and subtle degenerative changes in the articular cartilage of the treated elbow did develop. Recommendations for avoidance of radioulnar fixation were developed from these observations.

Osseous sequestration in the horse. A review of 68 cases.

Sixty-eight cases of cortical bone sequestration in 67 equine patients were reviewed with regard to the clinical presentation, method of treatment, and outcome. All lesions were located in skeletal areas with minimal soft tissue coverage, with 53% of them in the metatarsal and metacarpal bones. At the time of admission, 60% of the patients with limb lesions were lame; the majority improved with therapy. After sequestrectomy, there was a trend for surgical wounds which could be managed by primary closure to heal more rapidly (3.8 weeks) than wounds which required second intention healing (6.4 weeks). The appearance of healed wounds, as evaluated by owners, was acceptable in 45 cases. Dissatisfaction with the appearance of the healed wounds in 22 cases suggested a need to address the issue of cosmetic results.