406 women--about one-fifth of those requesting an induced abortion and sterilisation over a thirty-three-month period--volunteered to be allocated randomly to either a concurrent induced-abortion/sterilisation group or a group which was sterilised six weeks after abortion. The abortion-attributable and sterilisation-attributable complication rates of 3.8% and 5.2%, respectively, for the concurrent group did not differ significantly from the 6.7% and 6.9% rates for the interval group. The estimated 2%-10% of women who would have changed their minds must be set against the 4% of women who became pregnant again before being sterilised. Efforts should be made to identify women likely to regret sterilisation.

The effect of cimetidine on the risk of further bleeding shortly after acute gastrointestinal haemorrhage from peptic ulcer was investigated in a double-blind randomised trial. 34 patients were given cimetidine and 32 placebo, the two groups being matched for age, sex, and severity of haemorrhage. Further bleeding within a week of admission was detected clinically in 8 patients on cimetidine and 15 on placebo. Cimetidine had no effect on bleeding from duodenal ulcer, but only 2 of 14 patients with gastric ulcer treated with cimetidine bled again, compared with 10 of 19 patients on placebo. Cimetidine, therefore, may help to prevent haemorrhage from gastric ulcer but not duodenal ulcer.

The basic details of randomised clinical studies in cancer treatment under way in the United Kingdom were ascertained in a postal survey. The cancers of major interest were those of lung, breast, colon and rectum, and lymphomas and leukaemias. In general, only a small proportion of cancer patients are entered into clinical studies; and most of the individual studies aim for a small number of patients, with patient entry over a long period.

BAY g 5421, a glycoside-hydrolase inhibitor, produced symptomatic improvement in ten patients with the dumping syndrome. 100 mg BAY g 5421, given before a 50 g sucrose meal, produced pronounced attenuation of both hyperglycaemic and hypoglycaemic phases of plasma glucose levels; and it greatly reduced the rise in plasma levels of gastric inhibitory polypeptide and insulin. Gastric emptying, studied simultaneously by an isotopic method, showed little difference between tests, suggesting that the improvement achieved was not mediated by slowing gastric emptying.

The effect of bromocriptine on sexual activity was studied in male haemodialysis patients in a single-blind placebo controlled trial with random cross-over. At a dose of 2.5 mg bromocriptine twice day, plasma-prolactin concentrations were consistently reduced, while sexual function as assessed by a questionnaire was markedly improved. At the doses used, side-effects, particularly hypotension, were common, but bromocriptine helped to restore sexual function in dialysed patients.

In a double-blind study carried out between 1972 and 1975 in Hong Kong 100 heroin addict volunteers were initially admitted to hospital for two weeks for stabilisation on 60 mg of methadone before being assigned at random to two groups: one group received methadone (range 30--130 mg, average 97 mg/day); those in the other group had their dose of methadone reduced at the rate of 1 mg/day and were then maintained on placebo. All subjects were provided with a broad range of supportive services. After thirty-two weeks 10% of the controls were still on treatment, compared with 76% of those receiving methadone. At the end of the three-year project, only 1 of the original 50 placebo subjects still turned up for treatment (2%), whereas the retention-rate (proportion still on treatment) for methadone subjects was 56%. Subjects who had dropped out of the study and were readmitted for methadone treatment under known conditions had the same retention-rate as the original treatment group.

Tolfenamic acid (a potent inhibitor of prostaglandin biosynthesis), ergotamine tartrate, acetylsalicylic acid, or placebo was administered during 160 migraine attacks in twenty women in a double-blind, cross-over study. Tolfenamic acid and ergotamine were equally effective in reducing the duration and intensity of attacks, but side-effects, especially nausea, were less common with tolfenamic acid. This probably accounted for the patients' preference for tolfenamic acid. The effectiveness of tolfenamic acid in acute migraine attacks accords with the postulated role of prostaglandins in migraine.

To determine whether short-term thyroid hormone replacement prevents or merely delays temporary hypothyroidism after surgery for Graves' disease, serum T3, thyroid-stimulating hormone, and T4 were measured every 2 months for 18 months in two groups of Graves' disease patients who had had subtotal thyroidectomy. Group I (18 patients) were given T3 20 microgram four times daily from surgery through the twelfth postoperative month. Group II (18 patients) received no treatment. Hypothyroidism occurred at some time during the 18-month period in 10 group-II patients, but was temporary in 7. Temporary hypothyroidism did not occur in group-I patients, whose mean T4 level rose to that in group II within 2 months of T3 withdrawal. Short-term T3 replacement after surgery for Graves' disease thus prevents (and does not simply delay) temporary postoperative hypothyroidism without increasing the frequency of permanent hypothyroidism.

Of 1072 Chinese patients with radiographically active pulmonary tuberculosis and no microscopic evidence of acid-fast bacilli in sputum examinations, only 691 (64%) were sputum-culture negative. All patients were randomly allocated to selective chemotherapy (antituberculosis chemotherapy not being started until the activity of the disease had been confirmed), to daily streptomycin, isoniazid, rifampicin, and pyrazinamide for 2 months or 3 months, or to a standard 12-month control regimen. During the subsequent 12 months, 64% of the patients in the selective chemotherapy series started antituberculosis chemotherapy. Both 2-month and 3-month regimens were inadequate for patients whose pretreatment sputum cultures were positive (relapse-rates 14% and 7%, respectively, in patients with drug-sensitive strains) but in the patients whose first cultures were negative the relapse-rate was only 1% after both short-term regimens.