Preventing alcohol-impaired driving through community self-regulation training.

A community education program was designed to train the individual drinker to self-regulate his or her blood-alcohol concentration (BAC) below a level of impairment (.05 g/dl or 11 mmol/L). Drink calculators (cardboard wheels and wallet cards) were disseminated to customers of bars and licensed beverage outlets; bartenders and counter clerks were trained to demonstrate use of the calculators and demonstrations were presented in television spots. Program components were evaluated in three matched Vermont communities, one receiving the full community education program, one receiving the TV spots only, and one serving as control. After six months of intervention, a roadside survey of nighttime drivers (N = 892) indicated 5.3 per cent fewer drivers with BACs above 0.05 g/dl in the community program group and 1.0 per cent fewer in the TV-only group compared to the control group; however, substantially fewer drivers were found above .00 BAC in either program community than in the control. Drivers reporting heavy drinking and youthful drivers both indicated higher utilization of the materials than did other drivers. Although limited in scale and duration, this study suggests that a community education program can be effective in preventing alcohol-impaired driving.

Antihypertensive efficacy of once daily MK-521, a new nonsulfhydryl angiotensin-converting enzyme inhibitor.

The effects of the new nonsulfhydryl-containing oral converting-enzyme inhibitor MK-521 on blood pressure, heart rate, angiotensin-converting enzyme activity, plasma renin activity and plasma aldosterone concentration were assessed in 10 hypertensive patients. After a 2-week no-treatment period, patients received placebo and then 14 days each: MK-521 20 mg once daily, hydrochlorothiazide 50 mg once daily and the latter 2 in combination. During the last day of each treatment, the mean (+/- standard deviation) time-averaged (1- to 12-hour) standing diastolic blood pressure decreased from 106 +/- 8 (placebo) to 95 +/- 10 mm Hg with MK-521, 95 +/- 13 mm Hg with hydrochlorothiazide (p less than 0.05 vs placebo) and 88 +/- 11 mm Hg with the combination (p less than 0.05 vs all other treatments). The antihypertensive effect of MK-521 was maintained 24 hours after dosing. Heart rate did not change significantly after MK-521 treatment. MK-521 caused a marked suppression of converting enzyme activity for over 24 hours; plasma renin activity increased significantly after each active treatment and MK-521 significantly decreased the hydrochlorothiazide-induced elevation of plasma aldosterone concentration. In this short-term trial, MK-521 was well tolerated.

Prolonged toxicity of organophosphate poisoning.

A case of poisoning with a new organophosphate (fenthion) is reported in which the initial cholinergic crisis was delayed 5 days and recurred 24 days after ingestion. Psychosis was a persistent and sometimes singular manifestation. Because of the high lipid solubility of this pesticide, toxin analysis of repeated fat biopsies was an essential component of the management of this patient.