The importance of nonpharmacologic and pharmacologic interventions in the treatment of alcohol withdrawal is not known. A randomized, double-blind, placebo-controlled trial was conducted with 41 patients in alcohol withdrawal in an emergency department. The patients received either supportive care (10 min of standardized assessments, reassurance, reality orientation, and nursing care an hour) with three doses of sublingual lorazepam 2 mg every 2 hr (21 patients, drug group) or supportive care with three doses of sublingual placebo every 2 hr (20 patients, no-drug group). Immediately before each drug dose, the clinical course of alcohol withdrawal was assessed hourly by the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A). Interraters reliability in using CIWA-A was high. After each assessment, supportive care was given for 10 min before each dose. After completion of a 7-hr initial phase, patients were discharged and reassessed daily for 5 days. Thirty-seven patients (90.2%) improved in the initial phase. Treatment failures (CIWA-A greater than 10) were more common in the patients treated without drug (3/20, 15%) than in those treated with drug (1/21, 4.8%). Overall variations in intergroup CIWA-A scores during the initial phase were not significant. The rate of improvement of CIWA-A scores over the first 2 hr after drug was slightly faster in patients receiving lorazepam than in the control group. CIWA-A scores were the same during follow-up. These results indicate that most outpatients in mild to moderate alcohol withdrawal without medical complications improve without drug therapy in the emergency department setting.

No abstract

No abstract

This paper presents a new edition of the Back Plate Inscription (BPI) of the Antikythera Mechanism, a series of descriptions of circumstances associated with eclipses indicated cyclically by the inscriptions of the Mechanism's Saros Dial Scale. Our edition features several significant new readings as well as the confirmation of a disputed reading pertaining to one of the index letters by which the BPI's paragraphs are linked to the specific eclipse glyphs of the Saros Dial. On the basis of the new text, we deduce a revision of the established models for determining which lunar months of the Saros cycle had solar and lunar eclipse possibilities (EPs) and for assigning the solar EPs to paragraphs of the BPI. We further confirm that the entire extant part of the BPI comprises consecutive paragraphs concerning the solar EPs, all inscribed along the right side of the Mechanism's Back Plate, and we revisit the questions of what the BPI's predictions mean and how they relate to the model for the solar EPs. Abbreviations IG Inscriptiones Graecae IGUR Inscriptiones Graecae Urbis Romae PLond Greek Papyri in the British Museum POxy. astr. Jones 1999 Communicated by Jed Buchwald. Iversen is primarily responsible for Sects. 2 and 3, and Jones for Sect. 4, though both authors have made contributions to each other's sections.