Walking and talking victims of strangulation. Is there a new epidemic? A commentary.
Explore the source record for details and available documents.
Domestic Violence↗
Biomedical subjects
T Mills
Publications and source records attributed to T Mills.
Frequency and relationship of reported symptomology in victims of intimate partner violence: the effect of multiple strangulation attacks.
The objective of this study is to examine the correlation between the number of times a victim of intimate partner violence (IPV) has been strangled and symptom development subsequent to the attacks. One hundred and one female subjects responded to a series of questions regarding the history and characteristics of the strangulation and the development of specific medical symptoms. Multiple strangulation victims, individuals who had experienced more than one strangulation attack, on separate occasions, by the same abuser, reported neck and throat injuries, neurologic disorders, and psychological disorders with increased frequency. Despite the increased frequency of symptoms, only 39% of the multiple strangulation victims sought medical care. These observations strongly support the need for health care professionals to inquire about the incidence of strangulation, examine the victim closely for evidence of injuries caused by the attacks, and recommend immediate care in anticipation of the potentially long term medical needs.
Adult↗
Wireless endoscopy.
BACKGROUND: Miniaturization of electronic components may allow the construction of new types of endoscopes that no longer require external wires, cables, or optical fibers. Our aim was to assess the feasibility of wireless endoscopy and to construct experimental prototypes using miniature charge-coupled device cameras, light sources, microwave transmitters, and batteries. METHODS: Feasibility, dimensions of miniature components, and power requirements were assessed. Prototypes were constructed and tested using cameras, transmitters, and halogen lamps powered by small batteries; 10.6 and 0.187 GHz transmitters were used to transmit the video signal. RESULTS: Moving television images were transmitted through models, post-mortem and live porcine stomachs, to the external receiver. Transmission of images through the abdomen was tested by placing the device in a microwave-impermeable box behind a volunteer's back and the receiver in front of his abdomen. In other experiments the endoscope was used inside the human mouth. The device was placed surgically in the stomachs of 150 kg pigs in vivo and good-quality color television image reception was achieved. CONCLUSIONS: These experiments demonstrate the feasibility of constructing a new type of endoscope that can transmit moving color television images from the GI tract without requiring fiberoptic or electrical cables.
Animals↗
Risk assessment and suicide prevention in primary care.
General practitioners (GPs) are assumed to occupy an important position in the prevention of suicide through the introduction of risk assessment techniques commonly used in psychiatric practice. Despite this theoretical role for primary care services, it remains unclear how frequently GPs implement risk assessment in patients who may be vulnerable to suicide. To address this, a retrospective survey of probable suicides was conducted within a primary care setting utilizing a questionnaire of GPs who had experienced a patient suicide and was augmented by hospital and coroners' records. 85% of questionnaires were returned and 61 deaths were adjudged as suicides during the year long census period. 75% of suicides were male and 54% were aged under 35.28% were in contact with psychiatric services prior to death, although 60% had some diagnosis of mental disorder. GPs had little knowledge of a patient's life circumstances in up to half of cases. Recording of risk assessment occurred in 38% of subjects, was positively associated with prior psychiatric contact (p = 0.001) but negatively associated with presence of physical illness (p = 0.004), older patient age (p = 0.04), and GPs length in practice (p = 0.05). One GP felt their suicide case was preventable. The low rate of risk assessment and limited knowledge of patient lifestyle point to the need for active engagement of GPs in future suicide prevention strategies and should influence the content of training programs in primary care.
Adult↗
Effects of castration and testosterone replacement on veno-occlusion during penile erection in the rat.
AIM: To determine if androgens directly regulate veno-occlusion or if androgens act indirectly to maintain the penile structures which control outflow. METHODS: Using CASTRATE and TESTO rats, measurement was made of mean arterial pressure (MAP), intracavernosal pressure (CCP), and intracavernosal flow (CCF) during erection resulting from stimulation of the autonomic innervation of the penis. CCP and CCF were also measured during saline infusion into the cavernosal sinuses before and after treatment with sodium nitroprusside (SNP, a nitric oxide donor drug) to fully relax cavernosal smooth muscle. Penile tissue was also collected to measure the content of alpha actin and proline and hydroxyproline to determine if brief withdrawal of androgenic support led to changes in the number of smooth muscle cells or the collagen content of the tissue. RESULTS: Infusion of saline into the cavernosal sinuses demonstrated that veno-occlusion was defective in CASTRATE rats while veno-occlusion was fully functional in TESTO animals. Furthermore, veno-occlusion could be induced in CASTRATE rats if they were first treated with SNP. This observation suggests that failure of veno-occlusion in the CASTRATE rats is due to a deficiency in the production of NO resulting in a reduction in the degree of relaxation of the penile smooth muscle. The measurements of smooth muscle a actin and proline and hydroxyproline content of collagen showed that both were unaffected by castration and that the basic structure of the penis did not degenerate after one week without androgenic support. CONCLUSION: These results can be interpreted to mean that androgens control the veno-occlusive mechanism indirectly via a NO dependent mechanism and not by maintaining the structures of the penis which are essential to veno-occlusion.
Animals↗
Construction of a transcription map around the gene for ataxia telangiectasia: identification of at least four novel genes.
We have constructed YAC, PAC, and cosmid contigs in the ataxia-telangiectasia gene region and used the assembled clones to isolate expressed sequences by exon trapping and hybridization selection. In the interval between D11S1819 and D11S2029, exons and cDNAs for potentially 13 different genes were identified. Three of these genes, F37, K28, and 6.82, are large novel genes expressed in a variety of different tissues. K28 shows sequence homology to the Rab GTP binding protein family and gene 6.82 homology to the rabbit vasopressin activated calcium mobilizing receptor, while gene F37 has no homology to any known sequence in the database. Three further clones, exon 6.41 and cDNAs K22 and E74, from the interval between D11S1819 and D11S2029, appear to be expressed endogenous retrovirus sequences. The fourth large novel genes, E14, together with two further possible novel genes, E13 and E3, was identified from exons and cDNAs in the more telomeric 300-kb interval between markers D11S2029 and D11S2179. These are in addition to the genes for mitochondrial acetoacetyl-CoA-acetyltransferase (ACAT) and the ATM gene in the same region. Genes E3, E13, and E14 do not show homology to any known genes. K28, 6.82, ACAT, and ATM all appear to have the same transcriptional orientation toward the telomere.
Acetyl-CoA C-Acetyltransferase↗
Domestic violence in an inner-city ED.
STUDY OBJECTIVE: To determine the prevalence of domestic violence (DV) for male and female ED patients and to determine the demographics of DV. METHODS: The study design was a descriptive written survey of adults. We used the Index of Spouse Abuse (ISA), a previously validated survey tool. The study was set in an inner-city ED with approximately 75,000 patients annually, most of them indigent. Patients 18 years or older who were able to give consent were included. Patients were excluded if they had a language barrier, were a prisoner, or had never had a partner. All patients presenting during 31 randomly selected 4-hour shifts during July 1995 were considered for the study. DV was defined as either physical or nonphysical on the basis of ISA scoring. The prevalence was determined for present (in the preceding year) and past (more than 1 year ago) abuse. Four violence parameters were calculated for patients who had a partner at the time of presentation: present physical, present nonphysical, past physical, and past nonphysical. Only the "past" parameters were calculated for patients who had had a partner in the past but had no partner at the time of presentation. We used the chi2 test to determine individually significant predictors of the four parameters. Logistic-regression models were constructed to determine the significant predictors of DV. Associations among the present physical, present nonphysical, past physical, and past nonphysical abuse categories were determined with McNemar's test. RESULTS: We enrolled 516 patients, 233 men and 283 women. On the basis of ISA scoring, 14% of men and 22% of women had experienced past nonphysical violence (P=.02, men versus women), and 28% of men and 33% of women had experienced past physical violence (P=.35). Of the 157 men and 207 women with partners at the time of presentation, 11% of men and 15% of women reported present nonphysical violence (P=.20), and 20% men and 19% of women reported present physical violence (P=.71). Using logistic-regression models, we determined that women experienced significantly more past and present nonphysical violence but not physical violence than men. For all four parameters, the victim's suicidal ideation and alcohol use were independently associated with DV. The victim's family history was strongly associated with past abuse. Using McNemar's test, we found that physical and nonphysical abuse were correlated in the past and present. CONCLUSION: Using a validated scale, we found that the prevalences of physical DV for men and women are high and that they are not statistically different in this population. Using chi 2 testing, we found that women had experienced significantly more past nonphysical violence than men; using logistic regression we found that they experienced significantly more nonphysical violence (both past and present) than men. DV was frequently associated with suicidal ideation, alcohol use, and family history of violence.
Adolescent↗
Use of the NOSIE to predict assaults among acute psychiatric patients. Nurses' Observational Scale for Inpatient Evaluation.
OBJECTIVE: The study evaluated the Nurses' Observational Scale for Inpatient Evaluation (NOSIE), the Brief Psychiatric Rating Scale (BPRS), the Mini Mental State Examination (MMSE), and other measures as predictors of assaults that occurred during psychiatric hospitalization. METHODS: On admission, the MMSE was administered to 335 acutely ill psychiatric patients, and diagnostic and demographic data were recorded. Immediately after admission, patients were rated by nurses using the NOSIE and by psychologists using the BPRS. Patients who committed assaults during hospitalization (N = 47) and those who did not were compared, and relationships between several variables and assaults were evaluated by t tests, Mann-Whitney U tests, chi square tests, and analyses of variance. RESULTS: A high score on the irritability factor of the NOSIE and failure to complete the MMSE correctly predicted the occurrence or nonoccurrence of assault 81 percent of the time. None of the other variables examined were significantly related to assaults, including total scores on the BPRS and MMSE, psychiatric diagnosis, and several demographic variables. CONCLUSIONS: Scores on a test of distress level shortly after admission and failure to complete the MMSE on admission can help the clinician predict who will later engage in an assault.
Adult↗
Topical lidocaine adrenaline tetracaine (LAT gel) versus injectable buffered lidocaine for local anesthesia in laceration repair.
The objective of the study was to compare topical lidocaine adrenaline tetracaine (LAT gel) with injectable buffered lidocaine with epinephrine regarding pain of application or injection and anesthesia effectiveness. The study was a randomized prospective comparison trial in an urban emergency department. Physicians and patients ranked the pain of application, injection, and suturing according to a 10-cm visual analog scale. Sixty-six patients were entered, 33 in the LAT gel group and 33 in the injectable buffered lidocaine group. Injection was found to be significantly more painful than application of gel (P < 0.001). For anesthesia effectiveness, there was no difference according to patients (P = 0.48) or physicians (P = 0.83) for topical vs injectable forms. The number of sutures causing pain was not statistically different in the two groups (P = 0.28). In conclusion, LAT gel compared favorably with injectable buffered lidocaine for local anesthesia effectiveness and was significantly less painful to apply. It may be the preferred local anesthetic for this reason.
Administration, Topical↗
Cutting thread at flexible endoscopy.
BACKGROUND: New thread-cutting techniques were developed for use at flexible endoscopy. A guillotine was designed to follow and cut thread at the endoscope tip. A new method was developed for guiding suture cutters. Efficacy of Nd: YAG laser cutting of threads was studied. Experimental and clinical experience with thread-cutting methods is presented. METHODS: A 2.4 mm diameter flexible thread-cutting guillotine was constructed featuring two lateral holes with sharp edges through which sutures to be cut are passed. Standard suture cutters were guided by backloading thread through the cutters extracorporeally. A snare cutter was constructed to retrieve objects sewn to tissue. Efficacy and speed of Nd: YAG laser in cutting twelve different threads were studied. RESULTS: The guillotine cut thread faster (p < 0.05) than standard suture cutters. Backloading thread shortened time taken to cut thread (p < 0.001) compared with free-hand cutting. Nd: YAG laser was ineffective in cutting uncolored threads and slower than mechanical cutters. Results of thread cutting in clinical studies using sewing machine (n = 77 cutting episodes in 21 patients), in-vivo experiments (n = 156), and postsurgical cases (n = 15 over 15 years) are presented. CONCLUSIONS: New thread-cutting methods are described and their efficacy demonstrated in experimental and clinical studies.
Animals↗
Comets and life in the Universe.
The notion that comets supplied the primitive Earth with the requisite chemical species for the process of chemical evolution, which is widely held to have led to the origin of life on Earth, has now gained considerable intellectual momentum since its first formulation in 1961. In fact, in the fall of 1991, the University of Wisconsin-Eau Claire hosted a well attended scientific meeting devoted solely to the discussion of this topic, entitled Comets and the Origin and Evolution of Life [see Special Issue of Origins of Life, P.J. Thomas (ed), vol. 21(5-6)]. As a result of the above meeting, the recently completed COSPAR/World Space Congress Symposium on Extraterrestrial Organic Chemistry and the Origins of Life, and numerous independent reports, the role of comets in the Earth's biogenesis has been thoroughly addressed in the literature. At this time, in light of a few recent findings, we present here a concise review of this topic together with a brief discussion of the possible role of cometary material in the origin of life elsewhere in the Universe.
Carbon↗
On the levels of enzymatic substrate specificity: implications for the early evolution of metabolic pathways.
The most frequently invoked explanation for the origin of metabolic pathways is the retrograde evolution hypothesis. In contrast, according to the so-called "patchwork" theory, metabolism evolved by the recruitment of relatively inefficient small enzymes of broad specificity that could react with a wide range of chemically related substrates. In this paper it is argued that both sequence comparisons and experimental results on enzyme substrate specificity support the patchwork assembly theory. The available evidence supports previous suggestions that gene duplication events followed by a gradual neoDarwinian accumulation of mutations and other minute genetic changes lead to the narrowing and modification of enzyme function in at least some primordial metabolic pathways.
Bacteria↗
A comparative optical analysis of laser side-firing devices: a guide to treatment.
OBJECTIVE: To compare the optical characteristics of five different laser side-firing fibres used to perform deep laser coagulation of the prostate. MATERIALS AND METHODS: The intensity profile, angle of exit and beam divergence from the launch fibre were measured underwater (to simulate endoscopic conditions) for each fibre using both the Helium Neon(633 nm) and Nd:YAG(1064 nm) lasers. RESULTS: The intensity profiles and spot sizes varied among fibres but broadly fell within two groups characterized by large and small footprints (low and high power density). There was a maximum 5.5 fold difference in average power densities between the fibres. CONCLUSIONS: Not all side-firing devices are the same. Variations in the power density profiles among the fibres suggest that the choice of fibre is of critical importance in determining the type of laser tissue interaction (i.e. coagulation or vaporization) that will follow the use of that fibre.
Laser Coagulation↗
Catheter-associated urinary tract infections.
Explore the source record for details and available documents.
Bacteriuria↗
Comets and the formation of biochemical compounds on the primitive Earth--a review.
Thirty years ago it was suggested that comets impacting on the primitive Earth may have represented a significant source of terrestrial volatiles, including some important precursors for prebiotic synthesis (Oró, 1961, Nature 190: 389). This possibility is strongly supported not only by models of the collisional history of the early Earth, but also by astronomical evidence that suggests that frequent collisions of comet-like bodies from the circumstellar disk around the star beta Pictoris are taking place. Although a significant fraction of the complex organic compounds that appear to be present in cometary nuclei were probably destroyed during impact, it is argued that cometary collisions with the primitive Earth represented an important source of both free-energy and volatiles, and may have created transient, gaseous environments in which prebiotic synthesis may have taken place.
Atmosphere↗
The cometary contribution to prebiotic chemistry.
Different estimates based on dynamical considerations, lunar cratering rates, Solar System chemical abundances, and the single-impact theory on the origin of the Earth-Moon system suggest that comets and other related small, volatile-rich primitive minor bodies captured by the Earth during the early Archean must have been a major source of volatiles on our planet. It is likely that a substantial fraction of the organic molecules present in the colliding cometary nuclei, which may have included nitrogen bases and the precursors of amino acids, were destroyed due to the high temperatures and shock wave energy associated with the collision. However, the presence of H2O, CN, CH, CO, CO2 and other carbon-bearing molecules and radicals in the atmosphere of the Sun and in circumstellar shells around carbon-rich stars suggests that at least simple carbon species could have survived the cometary collisions. Under the anoxic conditions thought to prevail in the prebiotic terrestrial paleoatmosphere, the post-collisional formation of a large number of excited molecules and radicals, and the rapid quenching of the expanding gaseous ball may have led, upon rapid cooling, to the formation of molecules of biogenic elements and to their eventual deposition in localized environments where complex organic compounds of biochemical significance may have been produced and accumulated.
Carbon↗
A comparison of the reactivity of HLA-Aw33.1 and Aw33.2 with the 10th and 11th Workshop reagents.
Explore the source record for details and available documents.
Antibodies, Monoclonal↗