Infants have been fed with teats whose end-holes varied in shape and size. Two types of feeding-bottles were used. With conventional feeding-bottles, variations of teat-hole shape and size did not significantly alter the volumes of milk obtained at each suck. However, when an infant feeding-bottle was used which contained a valve, then variations in teat-hole shape and size did alter the volumes of milk obtained. The volume of milk obtained from a standard teat under such circumstances was the same as the volume previously calculated for breast-feeding.

The role of mycoplasmas in infertility was studied in 120 couples. During the twelve months of the study 27 couples (22-5%) conceived. T mycoplasmas were isolated from 63% of these couples, and Mycoplasma hominis from 18%, compared with 56% and 13%, respectively, in those who did not conceive. 88, with primary infertility of unascertained cause, took part in a controlled trial with doxycycline. The couples in the trial were allocated randomly to three groups: 30 received doxycycline, 28 received a placebo, and 30 couples were untreated. Although a twenty-eight-day course of doxycycline eradicated M. hominis and T-strain mycoplasmas from 27 (96%) of the 28 couples harbouring them, the rate of conception was no higher in those treated with the drug than in control groups. It is concluded that mycoplasmas are not associated with primary infertility and that, although doxycycline eradicates them, this drug is of no benefit in the treatment of primary infertility of unascertained cause.

Healthy medical students were divided into two groups. One group was given double the normal fibre intake of their diet as a high-fibre-containing breakfast cereal; the other group (control) was given a breakfast cereal containing negligible amounts of dietary fibre. Otherwise the nutrient intake of the two groups was maintained constant. No differences in the serum-cholesterol, serum-triglyceride, serum-calcium levels were found between the two groups during or at the end of the study. The addition of a tolerable amount of dietary fibre to the diet does not affect serum-lipids.

The results of a randomised trial of irradiation of the knee (synoviorthése), by intra-articular injection of yttrium-90, and surgical synovectomy have been compared in twenty knees in seventeen patients. The mean length of follow-up was 2 years. Relapse occurred in three out of ten irradiated knees, and in 2 out of 10 operated knees. Fewer irradiated knees were involved when generalised exacerbations of polyarthritis occurred. Irradiation carries a lower risk of complications than does synovectomy, it is more acceptable to patients, requires fewer days in hospital, and is cheaper; it would seem to be the treatment of choice in the older patient.

Sixty-three girls with covert bacteriuria were included in a controlled trial of therapy. Recurrent infection in the treated group was common and was not significantly different from the rate of persistent infection in the untreated control group. Two children in each group developed clinical pyelonephritis; the others have remained healthy and all of them have a normal rate of growth. 2 years after diagnosis three of the thirty-four children in the control group and one of twenty-six children in the treated group have radiological evidence of new scars of pyelonephritis. These changes were relatively minor and in both groups of children renal growth was similar to that in normal children. It is suggested that for most of these children therapy is not essential, and that when renal changes occur they are of little or no significance. Prescriptive screening for cobert bacteriuria of childhood cannot be recommended at present.

The effect of lowering raised plasma-free-fatty acids (F.F.A.) on the incidence of serious ventricular arrhythmias after myocardial infarction was assessed by a double-blind trial in eighty-one patients. A nicotinic-acid analogue (N.A.A.) with very slight haemodynamic effects was given within 12 hours of the onset of myocardial infarction to lower plasma-F.F.A. When treatment with N.A.A. was started within 5 hours of the onset of symptoms, the numbers of patients with ventricular symptoms, the numbers of patients with ventricular tachycardia were significantly reduced, provided elevated plasma-F.F.A. levels were rapidly lowered and maintained in the normal range throughout the treatment period. The incidence of R-on-apex T ventricular premature beats and beats in which the ectopic R wave interrupted the apex of the T wave of a previous ventricular premature beat was also reduced in patients receiving N.A.A within 5 hours of the onset of symptoms. Plasma-total-catecholamines and serum-creatine-kinase levels were similar in the N.A.A.-treated and placebo groups. N.A.A. rarely caused skin flushing, but vomiting occurred in some patients after many hours of treatment. These findings suggest that treatment directed towards stabilsing the matabolism of the ischaemic myocardium can be of therapeutic value and lead to fewer serious ventricular arrhythmias.

A prospective, randomised trial compared polygycolic-acid subcuticular skin closure with interrupted silk skin closure in 152 patients. There was no significant difference in the incidence of wound infection. The use of polyglycolic acid was associated with economic advantages.

Rubella-specific immunoglobulin responses in sera and nasopharyngeal secretions were compared in groups of adult females who had experienced naturally acquired rubella or infection induced by Cendehill, HPV77.DE-5, RA27/3 (subcutaneously and intranasally), and To-336 vaccines. Serum IgG and IgA and nasopharyngeal IgA responses after vaccination by RA27/3 intranasally most closely resembled those induced by naturally acquired infection. However, the other vaccines failed to induce a persistent local IgA response. Levels of local antibody induced by HPV77.DE-5 were especially poor. Virus-specific IgM was detected for prolonged periods. The highest levels and the most persistent response followed vaccination by HPV77.DE-5, four of five volunteers still having rubella-specific IgM at 1 year. Virus-specific IgM persisted for 6 months in seventeen of twenty-five (68%) and for a year in nine of twenty-four (38%) vaccinees. It was still present in four of nine (44%) naturally infected patients at a year.

A randomised trial comparing radiotherapy with a multiple chemotherapy regimen in 68 patients with small cell carcinoma of bronchus is reported. Although overall survival was poor, radiotherapy resulted in significantly longer survival, better amelioration of symptoms, and less side-effects than chemotherapy. Patients achieving complete or partial remission on radiotherapy relapsed mainly with extrathoracic disease, in contradistinction to those treated with chemotherapy whose thoracic disease recurred.

The results of short courses of chemotherapy using rifampicin plus isoniazid, supplemented for the first two months by streptomycin or ethambutol, in patients with newly diagnosed pulmonary tuberculosis, have been studied. 174 patients with little or no cavitation received six months chemotherapy. 1 (0.6%) failed to convert to culture negative during treatment and 5 (3%) relapsed in the twelve months after the end of treatment. In 177 patients with similar disease, twelve months chemotherapy was 100% effective in rendering the sputum culture negative and in preventing relapse in the six months after the end of treatment. 151 patients with more extensive cavitation received chemotherapy for nine months; this was 100% effective in sputum conversion and in preventing relapse in the nine months after the end of treatment. In 155 patients with similar disease, the eighteen-month regimen was uniformly successful in sputum conversion. The rifampicin plus isoniazed regimen was well tolerated, producing adverse effects which warranted withdrawal from the study in only 3.6% of patients. Comparison of ethambutol with streptomycin as a third drug given for the first eight weeks showed no significant difference in the rate of sputum conbersion nor in the incidence of relapse. Streptomycin produced significant adverse effects in 8% of patients whilst ethambutol caused none. Chemotherapy with rifampicin plus isoniazed for nine months, supplemented initially by ethambutol, is more acceptable than standard chemotherapy for eighteen months, is highly effective in sputum conversion, and has resulted in no relapses over a nine-month follow-up period. Further follow-up is being continued to confirm that relapse does not occur.

In a double-blind controlled trial lasting 12 months, long-term practolol therapy had no significant effect on plasma-lipid concentrations in twenty patients who had had acute myocardial infarction.