Quality of life of alcoholics and non-alcoholics: does excessive drinking make a difference in the urban setting?

The current study assessed whether perceived quality of life differed between alcoholics and non-alcoholics. Patients attending an urban-based hospital were screened for alcoholism using the CAGE questionnaire. Patients were recruited from an out-patient clinic setting as well as from an in-patient substance abuse unit. Quality of life scores were based on Chubon's (1987) Life Situation Survey. Results indicated that alcoholics experience a lower quality of life than their non-alcoholic counterparts regardless of setting; however, all patients reported experiencing poor life quality. The impact of alcoholism treatment programmes on patients already experiencing low quality of life is questioned.

The use of nurses to evaluate houseofficers' humanistic behavior

OBJECTIVES

1) To determine whether nurse evaluations of humanistic behavior discriminate between houseofficers in an internal medicine training program, and 2) to compare nurse and attending physician evaluations.

DESIGN

Prospective, six-month comparison of nurse and attending ratings of houseofficer humanistic behavior.

PROCEDURE

Using a six-item, Likert-scale humanistic behavior rating form, nurses and ward attendings evaluated 76 PGY-1, PGY-2, and PGY-3 houseofficers over a six-month period. Nurses and attendings voluntarily evaluated houseofficers on all inpatient units in both university and Veterans Administration teaching hospitals.

MEASUREMENTS AND MAIN RESULTS

Nurse ratings discriminated residents from one another throughout the six months of the study and over all units in both hospitals. Attending physician ratings were only moderately correlated with nurses' and were significantly more lenient. Exploratory analyses of the nursing evaluations revealed that female houseofficers received significantly more favorable evaluations than did men and that ward nurses were significantly more lenient than were critical care nurses. Nurse ratings did not differ by hospital, training year, or month of evaluation.

CONCLUSIONS

Nurses can provide information about humanistic behavior that will allow program directors to discriminate among different levels of houseofficer behavior. Information from nurses differs from that provided by attending physicians. Nurse ratings are affected by gender and by the type of unit from which they are obtained.

[Chronic subdural hematoma simulating transient ischemic attacks]

Chronic subdural hematoma presenting as transient ischemic attacks (TIA) is very rare. In a 74-year-old man in whom chronic subdural hematoma was responsible for recurrent attacks of local neurological deficiencies, the diagnosis was established by computerized tomographic (CT) scanning. Both TIA and chronic subdural hematoma usually occur in the elderly. Since the prognosis as well as the therapeutic approach are completely different in the 2 conditions, it is advisable to use imaging techniques, such as CT scanning, when there are recurrent TIA.

Precordial pain and electrocardiographic abnormalities simulating myocardial infarction associated with increased intracranial pressure in a child

Precordial pain associated with ECG ischemic pattern is a very rare phenomenon in children. Such findings were observed in an 8-year-old boy concomitantly with clinical signs of increased intracranial pressure resulting from occlusion of a previously installed atrioventricular shunt. When the shunt was replaced, chest pain and the ECG abnormalities disappeared. This experience would warrant alertness to the possibility that clinical and ECG signs of myocardial ischemia and other characteristic ECG abnormalities, as an expression of increased intracranial pressure, may occur not only in adults, but also in children.