Frequency and characteristics of the scaphoid cortical ring sign.

The scaphoid cortical ring sign (CRS) has been identified as a radiological indicator of ligamentous injury of the wrist. It has been associated with some pathokinematic states. There exists a range of wrist positions where the CRS may be normally present. The purpose of this study was to define the range of motion when the CRS can normally be observed on a standard posteroanterior radiograph and, in turn, to define the range where the CRS is not expected to be present. One hundred and nine posteroanterior radiographs of normal wrists were evaluated for the presence, partial presence and absence of the scaphoid CRS. The results were correlated with the radio-metacarpal (RM) angle in neutral palmar-dorsiflexion of the wrist. The range of wrist deviation for the wrists studied was -10.0 degrees (radial deviation) to 23.0 degrees (ulnar deviation). We defined the normal (and abnormal) range as being two standard deviations from the mean. The CRS was present in 25% of the radiographs evaluated. Moreover, the CRS was found to be present at 2.7 degrees (+/-7.7 degrees ) of radial deviation with a calculated range of -18.1 degrees to 12.7 degrees. The CRS was absent at 12.4 degrees (+/-11.7 degrees ) of ulnar deviation. It is concluded that the CRS observed at values less than 13 degrees of ulnar deviation may or may not be abnormal. If the CRS is observed at a RM angle of 13 degrees of ulnar deviation or greater, it should be considered pathological. The CRS, however, should be used in conjunction with other clinical findings of carpal instability.

Improving alcoholism treatment across the spectrum of services.

This article represents the proceedings of a symposium at the 2000 RSA Meeting in Denver, Colorado. The chair was Michael E. Hilton. The presentations were (1) The effects of brief advice and motivational enhancement on alcohol use and related variables in primary care, by Stephen A. Maisto, Joseph Conigliaro, Melissa McNiel, Kevin Kraemer, Mary E. Kelley, and Rosemarie Conigliaro; (2) Enhanced linkage of alcohol dependent persons to primary medical care: A randomized controlled trial of a multidisciplinary health evaluation in a detoxification unit, by Jeffrey H. Samet, Mary Jo Larson, Jacqueline Savetsky, Michael Winter, Lisa M. Sullivan, and Richard Saitz; (3) Cost-effectiveness of day hospital versus traditional alcohol and drug outpatient treatment in a health maintenance organization: Randomized and self-selected samples, by Constance Weisner, Jennifer Mertens, Sujaya Parthasarathy, Charles Moore, Enid Hunkeler, Teh-Wei Hu, and Joe Selby; and (4) Case monitoring for alcoholics: One year clinical and health cost effects, by Robert L. Stout, William Zywiak, Amy Rubin, William Zwick, Mary Jo Larson, and Don Shepard.

'When you were drinking' vs. 'in the past 12 months': the impact of using different time frames in clinical and general populations.

AIM: Different time frames have been used to ask about drinking in clinical and general populations. Surveys of clinical populations have asked about the quantity and frequency of drinking within the context of "when you were drinking". In general population surveys, the customary practice has been to ask about a period of time such as "the last 12 months". This paper compares answers to questions about drinking using both time frames. DESIGN: Bivariate chi-squares and multi-variate logistic regression analyses were used to compare consumption estimates across the two time frames for different demographic and drinking categories of respondents. SETTING AND PARTICIPANTS: In-person interviews were conducted with general population (N = 3069) and representative treatment samples (N = 381) in a northern California county. MEASUREMENTS: Respondents were asked about their drinking within the context of "the last 12 months" and only "when you were drinking". FINDINGS: There were no meaningful differences in aggregate measures of drinking based on the time frame of assessment in either sample. Drinking five or more drinks weekly was a significant predictor of consistent reporting of frequency of drinking among the clinical sample, and of reporting inconsistent frequency of drinking 12 or more drinks among the general population. Being female or being age 46 or over also was predictive of a "consistent" response in the general population for drinking 12 or more drinks; while being 46 or older, married, and white was predictive of consistent responses for drinking to intoxication in that population. CONCLUSIONS: Survey respondents do not average their drinking across a 12-month time frame that includes periods of abstinence; rather, they appear to answer only for the periods they were drinking.

Public support for warning labels on alcoholic beverage containers.

Warning labels are now required on alcohol beverage containers in the United States. Prior to the enactment of the warning label law, a random sample of adults in the general population of the United States were interviewed by telephone to assess baseline knowledge and support for the warning labels (n = 2006). This paper proceeds on the assumption that public support is crucial for sustained success of alcohol control policies such as the warning label mandate. We found that a vast majority (87%) of the respondents felt that alcoholic beverages should have warning labels about possible health hazards, with abstention as the most significant predictor of support. A majority of the respondents also felt that alcohol education, server intervention, treatment and counter-advertisement programs should be increased. A large minority felt that alcohol taxes should be increased store hours should be decreased, and the legal drinking age should be increased. Most respondents agreed that warning labels would not have much effect on heavy drinkers. When compared to responses to similar questions about alcohol control policies over the past 20 years, evidence supporting a conservative trend towards alcohol in the United States was found.

A comparison of a prospective diary and two summary recall techniques for recording alcohol consumption.

Recent reliability studies in which self reports of alcohol consumption taken from diaries have been compared against retrospective recall of alcohol consumption have yielded contradictory results. While the popular wisdom, supported by some excellent studies (Lemmens et al., 1988a; Poikolainen & Kärkkäinen, 1983) is that diaries yield the more accurate account, some studies have shown better results with a retrospective recall (Midanik et al., 1989; Simpura, 1988). The present study of 83 volunteer subjects compares a diary with two retrospective recall procedures--a graduated quantity frequency approach developed at the Alcohol Research Group and a beverage-specific, usual amount procedure used in the U.S. National Health Interview Survey series. Subjects were asked to complete all three procedures. Results show that both of the recall techniques tested achieved an acceptable level of reliability when compared against the results of prospective diaries. The implication of this is that the more easily administered recall techniques may be acceptable for many research purposes.

Queratose actínica: tumor epibulbar freqüente / Actinic keratosis: frequent epibulbar tumor

Três casos de queratose actínica säo apresentados como tumor epibulbar. Este tipo de lesäo pré-maligna é relativamente comum em países onde a populaçäo se expöe mais freqüentemente aos raios solares. Os diagnósticos diferenciais e o tratamento utilizado säo salientados

The demographic distribution of drinking patterns in 1984.

The demographic distribution of drinking and heavy drinking in a 1984 survey are presented to provide updated prevalence estimates for these phenomena. Several measures of drinking patterns are used, including: the frequency of drinking, the monthly volume consumed, the frequency of drinking five or more drinks on an occasion, the frequency of drinking eight or more drinks in a day, and the frequency of self-reported drunkenness. In most cases, the present results confirm earlier findings. However, the present data give better information on Black and Hispanic drinking patterns than was available in earlier surveys. Results not consistent with earlier studies are that there are contradictory findings regarding the relationship between socio-economic status and drinking and that the drinking patterns of divorced and separated men diverge from those of divorced and separated women.

Changes in American drinking patterns and problems, 1967-1984.

Data from a 1984 general population survey of drinking practices and problems in the United States are compared with those from identically worded items in a 1967 survey. Results indicate that beverage preference changed between 1967 and 1984. Americans consumed more wine and beer but fewer distilled spirits in 1984. However, the volume of drinks consumed did not change significantly. There were few significant differences in drinking patterns with the exception of a small increase in the percentage of men who were abstainers in 1984. Mixed findings were obtained with regard to drinking problems. Little difference was found over time in the proportion of respondents experiencing any of nine possible problem consequences, but there was an increase in the proportion who reported experiencing one of four possible dependence problems. Implications of this survey for the single distribution theory of consumption are discussed.

The presence of alcohol in four social situations: survey results from 1964 and 1984.

A set of questions about whether alcohol was served at four selected social situations was included in two general population surveys, one taken in 1964 and one taken in 1984. The results show that there has been a general increase in the frequency of reporting that alcohol was served at these situations. Cross-sectional results tended to support three hypotheses about drinking contexts: that alcohol is more often served among close rather than distant acquaintances; that heavier drinkers tend to socialize with other heavier drinkers, which results in wetter get-togethers for such groups; and that the frequency of serving alcohol reflects the demographic characteristics of the respondent-participants.

Drinking patterns and drinking problems in 1984: results from a general population survey.

Findings on alcohol consumption and alcohol problems from a 1984 general population survey are presented and compared to previous survey findings. Eighteen percent of all men and 5% of all women were classified as frequent heavy drinkers; 6% of all men drinkers and 2% of all women drinkers reported that they got "drunk" as often as once per week or more. A system for measuring drinking problems, based largely on the work of Cahalan and Room, is presented and explained. As when interpreting any system of measuring drinking problems in a general population survey, readers must be aware that the resulting prevalence rates are strongly influenced by arbitrary decisions about where cutpoints should be drawn. With this caveat in mind, the results show that 9% of men drinkers and 4% of women drinkers reported problematic drinking behavior at what is defined as a moderate level of severity. Similarly, 14% of men drinkers and 6% of women drinkers reported adverse tangible consequences of drinking at a moderate level of severity. The age and sex distributions of drinking, heavy drinking, intoxication, and drinking problems were as expected, with greater proportions of men than women reporting these things and greater proportions of younger than older drinkers reporting them.

Inconsistent responses to questions about alcohol consumption in specified settings.

In a 1979 national survey of drinking practices, a sizable number of respondents gave the inconsistent information that they drank more alcoholic beverages in bars and at parties than they drank overall. The percentage of respondents making such errors was too large to dismiss, and instead, it raised the possibility that the mention of specific contexts in questionnaire items produces response distortions. This suggests that caution should be used in the interpretation of survey data about drinking in specified contexts.