Changes in levels of alcohol consumption: United States, 1983–1988

Using data from the 1983 and 1988 National Health Interview Surveys, this note examines changes both in the prevalence of abstention and the prevalence of heavier drinking among drinkers in the United States. Changes are examined separately by gender and according to other sociodemographic characteristics often associated with different levels of alcohol consumption. Results suggest an increase in abstention and a decrease in heavier drinking between 1983 and 1988. For women, decreases in heavier drinking were found among those 18-44 years of age, among those employed, and among those divorced/separated or never married. For men, decreases in heavier drinking were found among those employed, among those with family income of $25000 or more, and among those married or divorced/separated. Changes both in abstention and heavier drinking were found to vary considerably by geographical region. These findings do not support results from other general population survey studies on alcohol use that suggest a stability in drinking levels, or even a slight increase in heavier drinking among men.     

TENSOR FASCIA LATA/GLUTEUS MEDIUS MUSCLE PEDICLE BONE GRAFT FOR NON-UNION OF FEMORAL NECK FRACTURES

Twelve male patients with non-union of fracture neck femur of 6-12 months duration were managed by open reduction and internal fixation and tensor fascia lata or gluteus medius muscle pedicle bone grafting through the anterior route. Internal fixation was done with Knowles pins and Asinis screws or combination of both. Union could be achieved in 11 out of the 12 cases. Functional recovery of hip was good in 9, fair in 2 and poor in one.KEY WORDS: Bone transplantation, Femur neck, Fractures, ununited, Fracture fixation, Tensor fascia lata     

A comparison of vincristine and doxorubicin infusional chemotherapy with methylprednisolone (VAMP) with the addition of weekly cyclophosphamide (C-VAMP) as induction treatment followed by autografting in previously untreated myeloma

In a sequential nonrandomized study, 204 consecutive unselected patients aged < 70 years received induction chemotherapy with infusional vincristine and adriamycin with oral methyl prednisolone (VAMP; n =75) or with additional cyclophosphamide, C-VAMP ( n =129). 38/129 C-VAMP patients also received verapamil during induction as part of a controlled trial with the aim to overcome drug resistance. A median of five courses (range 1–11) of chemotherapy were required before maximal response was attained and this was similar in both groups. An over-all response rate of 71% was noted at the end of induction. The complete remission (CR) rate with C-VAMP was 24%, which was significantly higher ( P =0.04) than the CR rate with VAMP alone (8%). The addition of verapamil did not alter the response rate of C-VAMP. Compliance to VAMP was overall 83% and not affected by the addition of cyclophosphamide. The proportion of patients going on to receive high-dose chemotherapy and an autograft was the same for VAMP and C-VAMP treated patients (71%). The median overall survival (OS) and progression-free survival (PFS) for the whole group were 4.4 years and 2.0 years and no difference in outcome was observed between the different treatment groups. Therefore the addition of weekly cyclophosphamide to VAMP induction therapy has significantly improved the response rates of previously untreated myeloma patients. C-VAMP was not more toxic and did not compromise the chances of receiving an autograft. Verapamil was without influence on any parameters in this study.     

Alcohol-related mortality in the United States, 1979–1988

Using alcohol-attributable fractions derived from studies of alcohol's involvement in various causes of death, this report presents trends in overall alcohol-related mortality for each year from 1979 through 1988. Age-adjusted rates show decreases in alcohol-related mortality for both sexes and for whites and nonwhites. Decreases occur for causes of death directly attributable to alcohol and for other diseases and injuries and adverse effects indirectly attributable to alcohol. Issues surrounding the use of currently available alcohol-attributable fractions for estimating alcohol-related mortality are discussed.