The effect of peroperative transfusion was studied in 27 patients who had never had a blood-transfusion or been pregnant and who were receiving their first cadaver renal allograft. 13 patients in the treatment group were given 2 units of whole stored blood at transplantation, whereas 14 patients in the control group were given no blood. Actuarial analysis after 2 years showed a graft survival of 85% at 1 year in the treated group compared with 34% at 1 year in the control group (p = 0.03). Transfusion of non-transfused patients during transplantation may be as effective as pregraft transfusion.

In a double-blind controlled clinical trial comparing the safety and efficacy of oral diethylcarbamazine citrate (DEC) with topical DEC for the treatment of onchocerciasis twenty men with moderate skin-snip microfilarial counts received daily therapy for 1 week, then weekly therapy for the rest of 6 months. The number of microfilariae per skin snip dropped quickly to 2% of initial levels and remained at low levels in those receiving oral DEC, and to 20% of initial levels in patients treated with DEC lotion. Side-effects in both groups included lymphadenopathy, fever, pruritus, rash, proteinuria, and chorioretinitis; they were commoner with topical DEC.

Heparin (1 IU kg-1 h-1) given intravenously for 3-5 days during and after operation in a double-blind randomised study, significantly reduced the frequency of deep-vein thrombosis detected by 125I-fibrinogen uptake, and pulmonary embolism. 22% (11/50) control patients and 4% (2/45) patients receiving heparin had deep-vein thrombosis or pulmonary embolism. Heparin administration was not associated with any increase in preoperative or postoperative bleeding.

The results of rectal anastomoses produced with a circumferential stapling gun were compared with those of a conventional hand suturing technique in thirty patients undergoing colorectal anastomoses for carcinoma and diverticulitis. The main advantage of the stapler is in anastomoses low in the pelvis where it allows relatively easy access to the extra-peritoneal fraction of the rectum. When the stapling gun was used the mean distance of the anastomosis from the anal margin was less and the length of postoperative hospital stay was reduced. The incidence of complications associated with the anastomosis was similar for conventional suturing and stapling.

In a randomised controlled trial somatostatin was compared with cimetidine in the treatment of severe and persistent gastrointestinal bleeding due to peptic ulcer. The study was of a sequential design and lasted 2.5 years, when the designated level of significance had been reached. Of the 20 patients studied, 10 received somotostatin and 10 received cimetidine. In 7 of the 10 pairs of patients somatostatin was more effective than cimetidine; in 2 pairs somatostatin and cimetidine were both ineffective; and in 1 pair they were equally effective. Somatostatin may therefore be suitable for controlling peptic-ulcer bleeding in many patients who are unsuitable for surgery.

The efficacy of verapamil (360 mg daily) in the treatment of patients with chronic stable angina pectoris was compared with placebo. 28 patients were studied in a placebo-controlled double-blind crossover trial of 2 weeks each and afterwards on long-term verapamil. Exercise tests were performed at the end f the placebo period, and after 2 weeks and 4 weeks on verapamil. On placebo, angina developed in all 28 patients during treadmill tests; the mean exercise time was 6.6 min (SEM +/- 0.5 min). The mean exercise time increased to 9.2 (+/- 0.8) min at 2 weeks, and 11.2 (+/- 0.8) min at 4 weeks on verapamil. In 15 and 20 patients out of the 28 angina did not develop during treadmill exercise at 2 and 4 weeks respectively. Trinitrin consumption also decreased. There was a significant improvement in ST-segment changes. Constipation (in 7 patients) and reversible PR-interval prolongation (in 2 patients) were the only side effects. No patient had clinical signs of heart-failure. Thus verapamil (360 mg daily) may be useful in the management of chronic stable angina.

In a multicentre controlled trial in the U.S.A. and Latin America 52 infants with meningitis and ventriculitis were randomly assigned to receive either systemic ampicillin and gentamicin or intraventricular gentamicin plus systemic antimicrobial agents. The aetiological agents most often encountered were Escherichia coli in the U.S. infants and Salmonella spp. in Latin American infants. Infants receiving systemic antibiotics plus intraventricular gentamicin had a significantly higher mortality rate (42.9%) than those who received systemic therapy only (12.5%). Duration of positive CSF cultures and morbidity rates were not significantly different in the two treatment groups. The concentrations of gentamicin in ventricular and lumbar CSF 1--6 h after an intraventricular dose of 2.5 mg gentamicin were 10--130 microgram/ml and 8--85 microgram/ml, respectively. The study was terminated early because of the higher mortality rate in the intraventricular-therapy group. Intraventricular gentamicin should not be used as routine treatment for neonatal meningitis caused by gram-negative enteric bacilli.