We performed 979 acupuncture treatments in 261 patients with chronic pain. A substantial number of patients stated that they had relief immediately following a series of four acupuncture treatments. It did not matter whether the needles were placed in the traditional meridian locations of in arbitrary fixed control points. Four weeks following treatment, 65% of the patients reported little or no reduction in the intensity of their pain, 17% reported a 50% reduction, and 18% at least a 75% reduction.

Propoxyphene napsylate and methadone hydrochloride were each administered under double-blind conditions to 36 outpatients for 21-day heroin detoxification. The initial dosage was 24 mg/day for methadone hydrochloride and 800 mg/day for propoxyphene napsylate. At these dosages, methadone more effectively suppressed the opiate-withdrawal syndrome, and patients remained in treatment longer in the methadone group (P greater than .05). In regard to heroin abstinence, however, results were not statistically significant in either group, as indicated by the number of patients whose urine was positive for morphine on admission and became negative during treatment, and the number who had morphine-negative urine at the conclusion of 21-day treatment. A one-month follow-up of patients showed that more patients given methadone had entered long-term medical maintenance while more patients given propoxyphene were heroin-abstinent. This study indicates that 21-day heroin detoxification, regardless of chemotherapeutic agent, yields a low rate of heroin abstinence.

No increased mortality trend attributable to tolbutamide is shown by an analysis of variance on logit-transformed data from the University Group Diabetes Program (UGDP) study. The UGDP's controversial finding of an increased rate with mortality subgrouped by "cardiovascular" causes is confirmed by the Biometric Committee's report, with reservations that failed to include overriding decisive factors. The basic problem is that inspected data set up the hypothesis (the increased cardiovascular mortality), and that the same data were used to test the hypothesis, so that resulting probability values no longer have the usual meaning. The problem was compounded by multiple testing of the data without adjusting the probability levels. When cardiovascular deaths were redefined as myocardial infarcts and sudden deaths, in an attempt to test a proposed etiologic inotropic hypothesis, no significant increase in cardiovascular mortality was found.

In two double-blind trials, volunteers challenged with rhinovirus were treated with aspirin or placebo. Aspirin treatment did not alter the rates of infection or illness but was associated with a moderate reduction in the frequency or severity of some symptoms. The overall benefit in rhinovirus infection was not statistically significant. Aspirin treatment appeared to cause a highly significant increase in the rate of virus shedding in treated subjects. The increase in virus shedding must be considered an adverse event that could influence the course of the disease in the individual and increase the likelihood of the spread of the infection to contacts.

The effect of daily administration of a single 300-mg tablet of allopurinol on serum urate levels was compared with the effect of divided doses of the drug (100 mg three times a day) in an open-labeled crossover trial of 20 patients with hyperuricemia and gout. Under both regimens of treatment there was a prompt fall in serum urate levels, and analysis of variance indicated no significant difference between the two modes of administration of allopurinol. Nor was there any significant difference in the minimum serum levels of oxypurinol. On the basis of this short-term study, the use of a single 300-mg tablet of allopurinol per day appears to be an effective means of lowering the elevated serum urate levels of individuals with gouty hyperuricemia and compares favorably with the results obtained by allopurinol in divided doses.

We reviewed the clinical data relating to the efficacy and safety of pharmacologic doses of ascorbic acid in the prevention and treatment of the common cold. Although one study tentatively supports the hypothesis that such doses of ascorbic acid may be efficacious, a second study by the same group did not confirm the significant findings, and no clear, reproducible pattern of efficacy has emerged from the review of all the evidence. Similarly, there is currently little adequate evidence on either the presence or the absence of serious adverse reactions to such doses of ascorbic acid, although many such reactions have been hypothesized. The unrestricted use of ascorbic acid for these purposes cannot be advocated on the basis of the evidence currently available.

Three hundred eleven employees of the National Institutes of Health volunteered to take 1 gm of ascorbic acid or lactose placebo in capsules three times a day for nine months. At the onset of a cold, the volunteers were given an additional 3 gm daily of either a placebo or ascorbic acid. One hundred ninety volunteers completed the study. Dropouts were defined as those who missed at least one month of drug ingestion. They represented 44% of the placebo group and 34% of those taking ascorbic acid. Analysis of these data showed that ascorbic acid had at best only a minor influence on the duration and severity of colds, and that the effects demonstrated might be explained equally well by a break in the double blind.

Concentrated potassium chloride produces ulceration of the gastrointestinal mucosa. Dilute solutions are frequently not acceptable to the patient. A tablet containing potassium chloride crystals suspended in a waxy matrix has been developed to avoid these drawbacks. We measured fecal blood loss by a radioactive chromium technique on 20 subjects during five days while they were given potassium chloride, 40mEq/day; ten subjects took a 10% solution; the others the waxy-matrix tablet. Fecal blood loss did not differ significantly between these groups. Mean fecal blood losses in both groups were slightly increased during the potassium chloride administration but never exceeded acceptable normal limits.

Dantrolene sodium (Dantrium) is a skeletal muscle relaxant, unique in that it acts on the muscle itself. It should be considered for use in patients with skeletal muscle spasticity who are in a stable neurological state. After careful adjustment of the dose, a substantial number of such patients will experience one or more of the following benefits: (1) a reduction in pain, (2) an increased ability to make use of residual motor function, (3) a reduction in the level of nursing care required, (4) an increased ability to utilize devices, and (5) an increased ability to participate in rehabilitation. The drug should not be used when reduced spasticity will decrease functional ability. The adverse effects generally are transient; some are the result of central nervous system depression.

In a double-blind evaluation, the efficacy of a combination of methyldopa with hydrochlorothiazide was compared with that of its components, methyldopa and hydrochlorothiazide. The combination was found to be more efficacious than either of its components. It reduced the arithmetic mean of the pressures of all patients from 170/116 to 133/95 mm Hg in four weeks. Despite the greater effect of the combination, side effects were mild.