A randomised controlled trial of antipyrine (phenazone) in the prophylaxis of neonatal jaundice was completed in 48 women. Treatment of mothers from the 38th week of pregnancy reduced neonatal plasma-bilirubin concentrations on the 4th day after birth by an average of 44%. Prophylaxis of neonatal jaundice merits a wider trial.

Four patients with myelomatosis (one IgG-chi-type, two IgA-chi, and one Bence Jones-x) were given human leucocyte interferon as the only treatment for from 3 to 19 months. Remission was complete in two patients and partial in the other two. Normal bone-marrow haematopoiesis was slightly inhibited. The disease has not so far progressed in any of the patients.

Acycloguanosine (9-[-hydroxyethoxymethyl]guanine) (Wellcome 248U) has a highly specific and potent antiviral action against herpes-simplex virus (H.S.V.) types I and II in cell-culture systems and in animal models of H.S.V. infection in the brain, skin, and eye. Its efficacy in man was tested in twenty-four patients with dendritic corneal epithelial ulcers treated by minimal wiping debridement. Patients were randomly allocated to treatment with 3% acycloguanosine eye ointment or placebo. There were seven recurrences or recrudescences of typical corneal epithelial herpetic lesions within 1 week of debridement in the twelve patients who received placebo, and no recurrences in the twelve who received acycloguanosine. Four further patients with dendritic ulcers have been electively treated with topical acycloguanosine alone. Their ulcers all healed briskly. No adverse effects were seen with the acycloguanosine therapy. These results establish that acycloguanosine is a clinically effective antiviral drug against H.S.V. infection in man.

In a trial lasting six months disodium cromoglycate (800 mg daily), sulphasalazine (2 g daily), and these two agents in combination were compared in 120 patients as maintenance treatment for ulcerative colitis. Relapse was defined as recurrence of colitic symptoms accompanied by sigmoidoscopic evidence of inflammation. The patients receiving disodium cromoglycate had a much higher relapse-rate than those taking sulphasalazine and the results with the two agents combined were little different from those with sulphasalazine alone. Disodium cromoglycate in the dose employed is greatly inferior to sulphasalazine as maintenance treatment for the prevention of relapse in ulcerative colitis.

A randomised double-blind trial was done to determine the effect on cervical ripening of 50 mg intravaginal prostaglandin F2 alpha (P.G.F.2 alpha) in a methyl cellulose gel given on the evening before surgical induction of labour. Patients were given either placebo or P.G.F.2 alpha and in both groups cervical stretching and sweeping of the fetal membranes was attempted. Of the 40 control patients, 3 had gone into labour and the mean improvement in the cervical score was 1.6 before surgical induction the next morning. However, 20 of the 40 patients receiving P.G.F.2 alpha went into labour before the proposed induction and the mean change in cervical score (5.1) was significantly greater than that in the placebo group. Of the 40 patients pretreated with P.G.F.2 alpha, 37 had improved cervical scores and significantly fewer required augmentation in labour with intravenous oxytocin than in the control group. No side-effects were experienced and the patients found the treatment acceptable.

The boys of Christ's Hospital experienced outbreaks of influenza A in 1972 (A/England/42/72), in 1974 (A/Port Chalmers), and in 1976 (A/Victoria). In each outbreak, the protective effect of inactivated influenza-A vaccine was limited to those boys, not already immune, who were vaccinated for the first time with the most up-to-date strain. Revaccination with the same strain did not increase the degree of protection, and revaccination with a later strain did not afford protection against subsequent challenge. The cummulative attack-rate in the three outbreaks was similar in all groups irrespective of vaccination history. These observations suggest that annual revaccination with inactivated influenza-A vaccine confers no long-term advantage.

An enkephalin analogue [D-Ala2, MePhe4, Met(o)-ol] enkephalin (DAMME), given intravenously to normal subjects raised serum prolactin and growth-hormone levels but lowered serum levels of luteinising hormone, follicle-stimulating hormone, cortisol, and corticotrophin. There was also a small fall in total glucagon and gastric inhibitory peptide (G.I.P.) and a rise in thyrotrophin. beta-Lipotrophin, motilin, vasoactive intestinal peptide, insulin, gastrin, and pancreatic glucagon were unchanged. Blood-glycerol increased, and blood lactate, alanine, and glucose fell. Prior administration of the opiate antagonist, naloxone, attenuated the hormonal responses to DAMME. This enkephalin analogue produces endocrine and metabolic changes in man which may be mediated through opiate-binding receptors both within and outside the brain. The enkephalins and related substances may provide an important link between perception, behaviour, and neuroendocrine regulation of hormone secretion and metabolism.

In an open trial, 96 patients with endoscopically proven peptic ulcers were randomly allocated to treatment with cimetidine (1 g/day) for periods of 3, 6, 9, or 12 months. After their courses of treatment, the patients were followed up for at least 6 months. In 92% the ulcers had healed after treatment for 1 month, and in a further 5% the ulcers healed during the next 2 months. Ulcers recurred during treatment in 24% of patients and within 6 months of withdrawal of treatment in a further 43%. In nearly a third of patients the recurrences were asymptomatic and were discovered only through routine endoscopic studies. Continuous treatment with full doses of cimetidine for a year seems to prevent relapse of the majority of ulcers which have healed during treatment; but it does not cure the ulcer disease, since relapse generally occurs quite rapidly when treatment is discontinued.

Twenty-seven patients with symptomatic gastro-oesophageal reflux received cimetidine 1.6 g daily for 6 weeks and matching placebo for 6 weeks in a randomised double-blind crossover trial. They complained of significantly more episodes of pain on placebo than on cimetidine (1186 vs 581) and consumed significantly more antacid tablets on placebo than on cimetidine (1645 vs. 1011). Cimetidine and placebo had similar effects on mucosal sensitivity to acid and on oesophagitis assessed endoscopically and histologically, suggesting that the symptomatic benefit is the result of a simple antacid effect.

The therapeutic effect of levamisole in patients with rheumatoid arthritis was evaluated in a sixteen-centre double-blind controlled study which compared continuous and intermittent levamisole treatment with placebo for six months. 363 patients with classic or definite rheumatoid arthritis and active disease were evaluated. Continuous and intermittent levamisole treatments were equally effective in controlling disease activity. 20% of patients had important drug-related adverse reactions. The results demonstrated that levamisole is an active drug in patients with rheumatoid arthritis.