Since 1975 four rounds of screening with modern mammography for breast cancer have been carried out among 30 000 Nijmegen women born before 1940. The results up to the end of 1981 shows that the odds ratio of screened vs unscreened subjects among women who died from breast cancer compared with women who did not, was 0.48 (95% confidence interval 0.23-1.00) in all age groups.

The frequency of micronuclei in cells scraped from inside the human cheek is a measure of chromosome breakage in earlier cell divisions, and it can be increased tenfold by carcinogenic stimuli. Supplementation for 3 months of the diet of 40 rural Filipino betel chewers with sealed capsules of retinol (100 000 IU/week) and beta-carotene (300 000 IU/week) was associated with a threefold decrease (from 4.2% to 1.4%) in the mean proportion of cells with micronuclei. This proportion decreased in 37 of the 40 supplemented subjects and no large increases were seen in any subjects. In 11 unsupplemented betel chewers in a nearby cluster of houses the mean proportion of micronuclei did not change (4.3% before and 4.8% three months later). This suggests the possibility that in this population an increase in the dietary intake of retinol and/or carotene may reduce the incidence of oral cancer, which is an important neoplasm in many parts of Asia.

In a study to compare the immunogenicity of human diploid cell rabies vaccine (HDCV) given by intramuscular or automatic intradermal jet injection, neither method of administration resulted in antibody levels predicted by previous studies. 49 days after starting a series of three 0.1 ml doses of HDCV given intradermally, 85 volunteers had a geometric mean titre (GMT) of neutralising antibody to rabies of 1:170. 9 concurrent control subjects who received 1.0 ml doses of vaccine intramuscularly had a GMT of only 1:269. Although standard potency testing did not demonstrate that the vaccine used was subpotent , these results strongly suggest that the immunogenicity of HDCV is substantially less than previously reported.

Rubella vaccination of schoolgirls aged 10-14 years started 13 years ago in Australia; the girls were vaccinated without prior assessment of their immunity. Non-pregnant seronegative women were also offered vaccination in family-planning clinics and post partum in obstetric units. Serological follow-up of 191 schoolgirls 5 years after vaccination and 56 girls 8 years after vaccination showed that all had detectable rubella antibody, whereas 24% of 239 unvaccinated young men of similar age (18-23 years) were seronegative. In 1983, 96% of 8226 pregnant women aged 12-53 years (mean 25.3 years) had detectable rubella antibody, and since 1977 there has been a striking reduction in the incidence of deafness due to congenital rubella. These results indicate that the rubella vaccination programme in Australia is having a significant impact on both the serological status of pregnant women and on the incidence of congenital infection.

A two-part study was done to assess the value of human fibroblast interferon (IFN-beta) in the treatment of condylomata acuminata. The first part was an open study of different IFN-beta preparations, which showed that intramuscular injection was the most suitable mode of administration of IFN-beta. In the double-blind placebo section 22 patients were given injections of 2 X 10(6) units IFN-beta or placebo for 10 consecutive days and followed up for 3 months. In 9 of the 11 in the IFN-beta group and 2 in the placebo group lesions disappeared from about 5 weeks after completion of the course of injections. After 3 months 8 of the non-responders were given a course of IFN-beta and all responded to treatment. None of those who had responded has had a recurrence, the disease-free period now being 12 months. Changes in (2'-5')oligo A synthetase levels in white blood cells confirm that intramuscular injections of IFN-beta produce a systemic response.

Patients with tibial fractures which had remained un-united for at least 52 weeks were randomly allocated to either active or dummy pulsed magnetic field stimulators and treated in full leg plasters for 24 weeks with a non-weightbearing conservative regimen, as is usual with such techniques. Fractures in 5 of the 9 patients with working machines united and fractures in 5 of the 7 patients with dummy machines also united. These early results of this double-blind trial are compatible with a difference in success rate at 24 weeks on active treatment of + 33% to -61% (95% confidence limits) compared with the success rate on the dummy stimulators. The high proportion of fractures uniting in the control group suggests that conservative management of non-union is effective and this may explain much of the success attributed to pulsed magnetic field therapy.

BM 13.177, a sulphonamide derivative, prevented platelet aggregation by thromboxane A2 in vitro and selectively inhibited contraction of isolated rabbit femoral arteries induced by two stable endoperoxide analogues. In a double-blind placebo-controlled study, oral BM 13.177 inhibited platelet aggregation induced by arachidonic acid, low dose collagen, and the two stable endoperoxide analogues, and slightly prolonged the bleeding time. Generation of thromboxane or of other prostaglandins was not affected. No side-effects were seen. BM 13.177 appears selectively and safely to block platelet and vessel wall thromboxane receptors and should be useful in elucidating the role of thromboxane A2 in disease.

In an attempt to determine the safety, tolerance, and prophylactic antiviral activity of high doses of recombinant DNA leucocyte interferon A a double-blind parallel-group study was started in 16 renal transplant recipients. All 16 patients had early rejection episodes. In all 8 interferon-treated patients and 1 placebo-treated patient this rejection, which was of the acute vascular humoral type, was steroid resistant. 3 interferon-treated patients also had transient nephrotic syndrome.

Freeze-dried human plasma rich in anti-lipopolysaccharide (anti-LPS) immunoglobulin G was used to treat septic shock (systolic pressure less than or equal to 80 mm Hg, central venous pressure greater than or equal to 6 cm H2O) in obstetric and gynaecological patients. Mortality in conventionally treated patients was 9/19 (47.4%) compared with 1/14 (7.1%) in anti-LPS-treated patients. Anti-LPS caused the mean arterial pressure to rise from 45.1 +/- 7.36 mm Hg to 69.1 +/- 9.07 mm Hg within 75 min of administration. The mean hospital stay of survivors was 28.1 days for controls and 14.2 days for the anti-LPS-treated patients. The development of complications of septic shock was much reduced in the treated group. Anti-LPS thus appears significantly to reduce mortality and morbidity in septicaemia.

A randomised, double-blind, placebo-controlled trial was conducted to evaluate the ability of RIT 4237 live attenuated bovine rotavirus (subgroup 1) vaccine strain to protect against natural rotavirus infection in children. 178 infants aged 8 to 11 months received a single oral dose of RIT 4237 vaccine or placebo and were followed up serologically and clinically during a subgroup 2 rotavirus epidemic. No side-effects attributable to the vaccine were observed. During the 5 months' observation after vaccination 2 of the 86 vaccine recipients and 18 of 92 placebo recipients had rotavirus diarrhoea lasting more than 24 h (p less than 0.001). The vaccine-protection rate was thus 88%. The 2 children in the vaccine group with rotavirus diarrhoea were regarded as primary vaccine failures since they had no detectable serum antibody responses after vaccination. Vaccine prepared from RIT 4237 strain of attenuated bovine rotavirus thus seems to protect children against heterologous subgroup 2 rotavirus diarrhoea.