Langdon Hospital

Denken des Dazwischen. Poetik des Medialen« lautete der Titel der Tagung im April 2022 an der HAW Hamburg, zu der dieser Beitrag entstanden ist. 1 In den Künsten zeigt sich diese Poetik, Aristoteles bezieht 1 In meiner 2022 verteidigten Doktorarbeit Radikale Kontingenz aushalten. Die Dialektik der ästhetischen Langweile in der Gegenwartskunst arbeite ich im dritten Kapitel die Frage des Dazwischen als Zwischenort und zeit weiter aus. Der hier vorliegende Beitrag ist eine kondensierte Form dieser Überlegungen, die sich aber in Teilen wortwörtlich mit dem Abschnitt zu Manon de Boer aus der Dis-

Abstract Background Adolescent and young adult drug usage has been on the rise, and it is essential to understand the factors that contribute to illicit drug use in the group. The study aimed to determine the prevalence, perceived health effects, intervention strategies, and challenges related to illegal drug use among adolescents and young adults in Abeokuta, Ogun State, Nigeria. Methods This survey was conducted in Abeokuta, Ogun State Nigeria between January- February 2023. It uses a purposive, descriptive study technique. A total of two hundred and fifty (250) questionnaires were administered to respondents (aged 0–30 years) to obtain information. Collected data was analyzed using descriptive and inferential statistics using Statistical Package for Social Sciences (SPSS version 21.0) software. The chi-square test was used to determine the association between parameters (p ≤ 0.05). Results The results revealed that the majority of the respondents take drugs (79%), use drugs due to peer group pressure (34.0%), to get high (33.6%), due to family problems (16.8%) and occasionally the curiosity to know how it works (28.8%). Furthermore, the majority always take marijuana/cannabis (28%), and occasionally take Loud and Shisha (30%) respectively. The drugs are often obtained from friends (30%), local shops (29.2%), local chemists (28.4%) and occasionally from unknown dealers (29.6%). Interestingly, the majority of the respondents strongly agree that illicit drugs can cause cardiovascular, hepatological, pulmonary, neurological and nephrological conditions and that as an effort of intervention, the government provides anti-drug campaigns, drug education, drug awareness, research and non-governmental organization (NGO) liaison. The chi-square test revealed a significant association between age group and drug use due to peer group pressure, getting high, curiosity about how it works and family problems. Parental status and curiosity about how drugs work. Additionally, there is a significant association between the literacy level of the study group and parents with family problems. (p ≤ 0.05). Conclusions Multiple factors have exposed adolescents and young adults in the study area to drug use this includes peer pressure, curiosity, family issues, and the literacy level of both the study group and their parents.

BackgroundDogs with protein‐losing enteropathy (PLE) are at risk of developing a hypercoagulable state, but the prevalence of hypercoagulability in dogs with chronic enteropathies (CE) and normal serum albumin concentration is unknown.HypothesisDogs with CE are predisposed to a hypercoagulable state as assessed by thromboelastography (TEG) independent of serum albumin concentration.MethodsDogs with chronic gastrointestinal signs from suspected inflammatory CE between 2017 and 2019 were included. Thirty‐eight were evaluated; every dog had a CBC, serum biochemistry panel, and abdominal imaging performed. The Canine Inflammatory Bowel Disease Activity Index (CIBDAI) was calculated. Thromboelastography was performed at presentation, and reaction time (R), kinetic time (K), α‐angle, maximal amplitude (MA), and global clot strength (G) were recorded. Dogs were considered hypercoagulable if the G value was ≥25% above the reference interval.ResultsSeventeen of 38 (44.7%; 95% confidence interval [CI], 28.6‐61.7%) dogs with CE were hypercoagulable. The G value did not differ between the 19 dogs with normal (≥28 g/L) serum albumin concentrations (9.05 kdyn/cm2; 95% CI, 7.26‐10.84; SD 3.71) and 19 dogs with hypoalbuminemia (11.3 kdyn/cm2; 95% CI, 9.04‐13.6, SD; 4.7; P = .11). The G value was negatively correlated with hematocrit, serum albumin concentration, and duration of signs and positively correlated with age.Conclusions and Clinical ImportanceDogs with CE and normal serum albumin concentration can be hypercoagulable as measured by TEG.

There are currently no evidence summaries on wounds in the horse. To develop evidence-based guidelines on wound management in the horse. Evidence review using the GRADE framework. Research questions were proposed by a panel of veterinarians, and developed into PICO format. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Searches for human evidence summaries were conducted in the NICE, Cochrane and JBI databases. Final recommendations were based on both veterinary and human evidence. The research questions were categorised into three areas: A. Wound lavage and topical treatments; B. Wound debridement and closure; C. Therapeutics for wound healing. Three hundred and six veterinary publications were identified across thirteen different topics. Fourteen papers were assessed using the GRADE criteria. Twenty-five human evidence summaries were reviewed. The results were developed into recommendations: Wound lavage and topical treatments: (i) Tap water should be considered instead of saline for lavage; (ii) Povidone iodine lavage should be considered for contaminated wounds; (iii) Topical silver sulfadiazine may not be suitable for acute wounds; (iv) Optimal lavage pressures are around 13psi. Wound debridement and closure: (i) Debridement pads should be considered for wound preparation; (ii) Larvae debridement should be considered in selected cases; (iii) Hydrosurgery should be considered in acute contaminated wounds. Therapeutics for wound healing: (i) Honey may reduce duration of some phases of wound healing. There was insufficient evidence to draw conclusions on the use of chemical debridement, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identify optimal concentrations of antiseptic lavage solutions. Low quality evidence in veterinary literature; majority of recommendations were based on human evidence. These findings should be used to inform decision-making in equine primary care practice.

Adult forensic mental health services provide care and treatment to individuals with complex offending and mental health histories. However, little attention has been paid to the parents of those receiving care within them. This research explored the experiences of parents with an adult son or daughter with mental illness in a medium secure mental health unit. Transcripts from semi-structured interviews were analysed using interpretative phenomenological analysis. This led to the identification of three superordinate themes: 'Something's not right'-onset of mental distress; 'It's a terrible battle'-relating with professionals; and 'A very sad fact of life'-caring with no end in sight were identified which together contained nine subordinate themes. The onset of the mental distress was narrated as overwhelming, frightening, and confusing with experiences of violence. Services were seen as invalidating, and interactions with them characterized as a battle. Poor information and involvement were a common experience. Whilst diagnosis was a relief to some, the ongoing sense of loss and burden were clear. Staying connected and hopes for the future were also described. It is clear from this study that mental health services need to do more to engage and foster trust with parents from the outset and to offer support for this group. If secure services were to view parents as 'forensic carers', this may help improve respect and engagement between services and carers. Services and policymakers should strive to foster high-quality family involvement as part of developing social inclusion.

BackgroundDown's syndrome (DS) is a genetic anomaly, which undergoes increased morbidity and mortality when associated with congenital heart disease (CHD). The aims of the study were to determine the prevalence of CHD and pulmonary hypertension (PH) in DS.MethodsOne hundred twenty-seven patients with DS living in Mexico City were evaluated by physical exam, electrocardiogram and echocardiogram.ResultsCHD was found in 40%. In 80% (n = 102) PH was present [systolic pulmonary artery pressure (SPAP) of 47 ± 19 mm Hg and mean pulmonary artery pressure (MPAP) of 32 ± 11 mm Hg]. Patients with CHD and PH were classified as having 1) no shunt (n = 18) with SPAP of 37 ± 9 mm Hg and MPAP of 25 ± 6 mm Hg and 2) with shunt (n = 26) with PASP of 57 ± 29 mm Hg and MPAP of 38 ± 19 mm Hg (p ≤ 0.001). In those without CHD or with CHD without shunt (n = 76), SPAP was 37 ± 19 mm Hg and the MPAP 25 ± 6 mm Hg. The prevalence of PH in DS was 5.9% at one year and 15% at 10 years. The odds ratio of PH in DS with CHD was 7.3 vs. 3 without CHD.ConclusionDS has a high prevalence of CHD and PH. PH prevalence increases when it is associated with CHD. The pathophysiology of PH in DS without CHD should be studied in the near future. Echocardiography is an indispensible tool for evaluation of DS.

Congenital lobar emphysema (CLE) is a notable cause of respiratory distress in neonates, however it remains a diagnostic challenge due to inadequate facilities and low level of experience. The management of this condition also is a bigger challenge due to paucity of expertise and relatively non-existent well-equiped neonatal intensive care unit in this part of the world. Here we present the case of a 5- day old baby who presented at Lagoon Hospital, Apapa with history of severe respiratory distress since birth. CT scan of the chest confirmed an emphysematous left upper lobe with contralateral mediastinal shift. The baby had a left posterolateral thoracotomy with left upper lobectomy and thereafter was electively ventillated for forty eight hours in the neonatal intensive unit. He had an uneventful postoperative course and was discharged from the hospital within one week forfollow-up in the clinic.

To assess the performance of three bench-top chemistry instruments for the analysis of canine effusions. Acceptable results were compared with those obtained by a reference chemistry analyser. Total protein, albumin, creatinine and bilirubin concentrations were measured in 74 effusions using the VetScanVS2, VetTest8008 and SpotchemEZ analysers. Cholesterol and triglyceride concentrations were also measured by the VetTest and Spotchem. Results were analysed using Westgard's error analysis, Spearman's correlation, Bland-Altman plots and Deming regression. Results were considered acceptable when observed total error (TE(obs) ) was less than allowable total error (TE(A) ). VetScan error analysis revealed acceptable results for total protein (TE(obs) =1.11, TE(A) =4.7) and creatinine (TE(obs) =42.2, TE(A) =78.1). Correlation was fair for protein (r(s) =0.66) and creatinine (r(s) =0.76), but poor and not significant for bilirubin (r(s) =0.01, P=0.08), precluding error analysis. VetTest error analysis was acceptable for creatinine only (TE(obs) =5.55, TE(A) =25.5). Correlation was good (r(s) =0.81). The difference plot revealed a bias (95% confidence interval) of -1.5 (-37 to 40) and four outliers. The Spotchem did not generate a precise arithmetic value in most (56.9 to 73.6%) samples, precluding further analysis. Acceptable results were obtained for total protein (VetScan) and creatinine [Vetscan, Vettest (with good correlation)]. The Spotchem is of limited value in canine effusion analysis.

Aims and MethodTo develop standards for physical health monitoring in patients on antipsychotics in a forensic environment. We reviewed recommendations for physical health checks from key publications and then agreed a consensus on what to monitor and how often.ResultsWe developed a standardised form to ensure the requisite minimum monitoring is performed when a patient is newly prescribed an antipsychotic drug or the dose is increased, when an abnormality is detected and for routine annual physical health monitoring.Clinical ImplicationsWe have produced a pragmatic solution to the gap between the recognised risks to physical health of individuals treated with antipsychotic medication and the need for clear, unambiguous standards of physical healthcare.

Introduction. Memory for public and autobiographical events was investigated in people diagnosed with depression, schizophrenia, and a group of healthy controls. The aim was to determine whether the overgeneral memory effect emerged in clinical conditions other than depression and in memory domains other than autobiographical. Methods. 36 participants, 12 in each group, were administered four measures comprising the Hospital Anxiety and Depression Scale, the Autobiographical Memory Test (AMT), the Autobiographical Memory Interview (AMI), and a Public Events Memory Test; the latter developed by the authors and based on the AMT. Results. A pattern of overgeneral autobiographical memory retrieval was found in both clinical groups. A similar pattern in retrieval of public events was also found in people diagnosed with depression and schizophrenia, indicating that overgeneral memory was characteristic of neither clinical condition nor was it associated with a particular memory domain. Conclusions. The findings suggest that overgeneral memory retrieval may represent a fundamental flaw in memory that arises when resources are limited. These findings are discussed in light of current theories of overgeneral memory retrieval.