The relationship between alcohol and head injury and its effect on the conscious level

The incidence of head injury has risen in recent years and now accounts for almost one-third of acute male surgical admissions to the Western Infirmary, Glasgow. A prospective study has established that in Glasgow alcohol is a major associated factor, 62% of males and 27% of females having detectable levels in the blood (greater than 5 mg/100 ml); in these patients the mean level was 193 mg/100 ml in men and 165 mg/100 ml in women. The alcohol level was significantly higher in patients who had had 'a fall under the influence', or had been the victims of an assault, than in those involved in traffic or other accidents. This suggests that alcohol may be an important contributroy cause of head injuries in this city. Depression of the conscious level occurred at blood alcohol levels aroung 200 mg/100 ml, but a significant number of patients in coma had a serious head injury.

Blood ethanol concentrations in patients attending special clinics in Glasgow

Blood samples for measurement of ethanol concentration were taken on a routine basis from 543 male and 158 female patients attending Special Clinics in Glasgow. Ethanol was detected in 56 (10-3 per cent.) of the men and eight (5-1 per cent.) of the women, and at concentrations in excess of 0-1 g./l. in 37 (6-8 per cent.) and three (1-9 per cent.) respectively. In nine men and one woman, the blood ethanol concentration was over 0-8 g./l. when they attended the clinic. The majority (84 per cent.) of positive findings were obtained in specimens collected after 2 p.m. and one-quarter on Tuesday afternoons, the local half-day. The other peak periods related to attendance at football matches on Wednesday evenings, and to receiving wages on Friday mornings. Male new patients attending a clinic for the first time had the highest incidence, 32 (11-6 per cent.) having detectable amounts of ethanol among whom 26 (9-4 per cent.) had levels in excess of 0-1 g./l., compared with only 4-1 per cent. among those either returning to the clinics with a fresh infection or on surveillance. Only 5 per cent. of female patients attending for the first time and 3 per cent. of those on surveillance had detectable amounts of ethanol in the blood, compared with 9 per cent. of those few returning with fresh infections. Levels in excess of 0-1 g./1. were only found in promiscuous women. Those with concentrations in excess of 0-8 g./1. were unreliable attenders. Only one, a known alcoholic, completed surveillance; one defaulted after his fourth visit, four after the second, and four after the first visit.

Preparation and monitoring of marijuana smoke condensate samples

The objective of this study was the production of smoke condensate from the marijuana cigarettes on schedule for the bioassay study and involved quality control on each batch of smoke condensate. Examination of the condensate production data (tables 1 and 2) reveal that it is not possible to strictly control the butt length of cigarettes when smoked on a robot smoking machine thereby accounting for some variation in the yield of the dry particulate matter and increment9-tetrahydrocannabinol. No increment8-tetrahydrocannabinol was detected in any batch of the smoke condensate. Recently, Hoffman and co-workers (13) have reported that marijuana that exhibited carcinogenic potential similar to tobacco cigarette smoke condensate in the dermal assay in mice.

Attitudes towards alcoholism

An attitude survey of psychiatrists has shown that alcoholism is the least favoured of the organic and psychiatric illnesses. They considered that this attitude was shared by general physicians and surgeons. The unfavourable attitudes towards alcoholism are unlikely to improve the success of treatment programmes. It is suggested that education within the professions is needed.

Effect of teaching on students' attitudes to self-poisoning

The attitudes of students, resident house physicians, and medical social workers towards 10 medical conditions were assessed in relation to both personal attitudes and the opinions expressed of the attitudes of the medical profession. Final-year students and house physicians showed unfavourable attitudes towards self-poisoning in contrast to fourth-year students and medical social workers. The fourth-year students were given the opportunity to admit patients referred to hospital with self-poisoning and visited the family doctor and the patient after discharge. After this exposure there was a subjective impression that the students became more interested in the problems of use self-poisoned patients, and this was supported by a review of their attitudes at the end of the teaching project.

Attitudes towards self-poisoning

Self-poisoning now constitutes one of the prime emergencies in hospital medical practice. This paper describes the results of the study of the attitudes of physicians and senior nurses towards several common illnesses in the medical wards. The junior doctors and the nurses who frequently have primary responsibility for the care of the self-poisoners tend to show unfavourable attitudes towards these patients.

Modes of admission to hospital: a survey of emergency admissions to a general medical unit

In a survey of the modes of referral and disposal of "acute patients" to a general medical unit during the period 1 February 1968 to 31 July 1970 only 1,432 out of 3,455 were referred by general practitioners. There was a high incidence of self-referral to hospital, and this trend was on the increase. A large percentage of self-referred patients came from their homes, and 65-77% of these arrived by ambulance ordered by themselves.

Clinical studies on the effect of laevulose on the rate of metabolism of ethyl alcohol

A study of the effect of laevulose upon the rate of metabolism of ethyl alcohol was undertaken. The rate of disappearance of ethyl alcohol from the blood of normal volunteers was estimated under normal conditions and also following the administration of oral and intravenous laevulose. These results were compared with the rate of disappearance of ethyl alcohol from the blood of inebriated patients under normal circumstances and following intravenous laevulose.

The investigation confirms that ethyl alcohol is metabolised at a constant rate which varies from individual to individual and that the administration of laevulose significantly increases this rate of metabolism.

It is suggested that laevulose is helpful in the management of inebriated patients in whom there is clinical suspicion of accompanying head injury.