Cluster headache.
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Biomedical subjects
Publications and source records attributed to J S Olin.
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A profile of the demographic, sociologic, drug use, and drinking characteristics of a large group of inpatient alcoholics has been constructed as background for discussion of the clinical significance of these factors as determinants of physical morbidity in hazardous drinkers. Factors specifically considered include sex, skid row status, social class, and abnormal use of drugs of dependence, the amount of alcohol consumed and duration of drinking, drinking pattern, and type of beverage. While heavy drinking is of primary importance, the physical disease profile found in hazardous drinkers is modified by certain host and environmental characteristics. The implications for treatment planning and preventive programs are considered.
The physical disease profiles of 135 female and 736 male inpatient alcoholics, similar in age, social class, and referral pattern, were compared to further clarify the widespread clinical impression that female alcoholics are more illness-prone. Although the women had been drinking hazardously for fewer years, at admission the prevalence of most diseases was similar in men and women. There was, however, an excess of anemia in women and of fatty liver and chronic obstructive lung disease in men. Furthermore, the average duration of hazardous drinking before the first recorded occurrence of almost all illness events was shorter in women, the sex differences being statistically significant for fatty liver, hypertension, obesity, anemia, malnutrition, gastrointestinal hemorrhage, and an ulcer requiring surgery. These findings suggest that the development of physical morbidity in relation to hazardous drinking may be accelerated in women.
The lifetime physical disease profiles of 122 lower and 724 middle class non-skid row alcoholics admitted to an inpatient treatment facility were compared to further clarify the significance of social class as a determinant of morbidity in alcoholics. The overall severity of physical disease and the frequency of all recorded lifetime illness diagnoses were greater in the lower than in the middle class. The former experienced more trauma, genitourinary disorders, venereal disease and malnutrition, as well as small excesses of respiratory and nervous system disorders. There were no class differences in the lifetime frequencies of liver and biliary tract, gastrointestinal, cardiovascular, endocrine and metabolic, integumentary, locomotor and haemopoietic disorders, or in the incidences of a number of disease entities including acute brain syndromes and chronic brain damage. The drinking patterns of the classes were similar, but the average duration of hazardous drinking was longer and the average current consumption was greater in the lower class. There were no class differences, however, in the average duration of hazardous drinking before the first occurrence of certain diseases. The referral sources of the classes were significantly different. Possible explanations for the differences between the findings of this and earlier studies are discussed.
The physical-disease charcteristics of 125 skid row and 736 non-skid row male alcoholics were compared in detail to determine whether skid row alcoholism is characterized by a distinct medical, as well as a social, profile. Trauma, tuberculosis, venereal disease, and malnutrition were more common in the skid row alcoholics. Epilepsy, peripheral neuritis, acute brain syndromes, chronic brain disease, and lifetime recordings of all nervous system illnesses also occurred more frequently in the skid row group, as did gastritis, gastrointestinal hemorrhage, ulcer surgery, and postgastrectomy syndrome. Fatty liver, hypertension, ischemic heart disease, cardiomyopathy, and cardiovascular illnesses of all kinds, however, were less common. The skid row medical profile is, in part, the product of a unique sociologic environment. Thus, skid row alcoholism may be viewed as a distinct sociomedical entity.
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From skid row, 227 chronic "drunks", inmates of the Toronto Jail, were studied to determine the physical features and illnesses of this group. Complete physical examinations, liver function tests, routine hematology, urinalysis, chest radiographs were carried out and previous hospital records were obtained for each man. The data were analyzed by IBM computer and reported in terms of body systems. Items that occurred in sufficient frequency were separated out and listed to compile a "skid row" syndrome. The men averaged 45 years of age, had been drinking heavily for 20 years and had four drunken convictions a year. Tuberculosis was found in 8.8%. Epilepsy was confirmed in 8%. Cirrhosis of the liver was definite in 3% of the group; 75% were under the Canadian average weight, and 25% had significant body deformities. It was estimated that, if necessary therapy was carried out, 90% of the men would be able to perform useful labour.
Of 227 chronic alcoholics studied in jail, 20 (9%) had a previous diagnosis of tuberculosis. The chest radiographs of 202 of these inmates were compared with those of 187 inmates serving sentences for other offences. Significant findings compatible with tuberculosis were noted in 34 of 202 (16.8%) chronic alcoholics and in two of 187 (1.1%) other offenders. Tuberculin testing of 98 inmates revealed that 80.6% of the chronic alcoholics and 33.3% of the other offenders had positive skin tests. It is suggested that the mixing in jail of a potentially highly infectious group with susceptible individuals is undesirable and that other methods of management should be considered.