60 premenopausal women were assessed before and after hysterectomy for menorrhagia or fibroids or both. Their mood, sexual functioning, and plasma oestrogens and gonadotrophins were regularly assessed for a period of up to 3 years. Patients were randomly assigned to receive either oestrone sulphate or placebo tablets during the trial. No evidence was found that this group of patients showed depression or sexual difficulties related to the hysterectomy. In comparison with their baseline gynaecological condition, they showed improved mood and vigour and unimpaired sexual activity.

The blood pressures (BP) of the parents of a group of students were determined and two subgroups of students were defined, one with (PHT group) and one without (PNT group) a familial predisposition to hypertension. Observations were made in both groups during three periods of modified dietary electrolyte intake: (i) no-added sodium (low Na), (ii) no added sodium with potassium supplementation (low Na/high K), and (iii) sodium supplementation (high Na). The diets were given in random order. At the start of the trial, while the students continued their customary diet, the PHT group had higher systolic and diastolic pressures and plasma noradrenaline levels than the PNT group. At the end of 4 weeks of the high Na diet, the BP levels of both groups were significantly higher than those after the low Na diet. In contrast, when the low Na diet was supplemented for 2 weeks with potassium, BPs of the PHT group fell significantly, while those of the PNT group rose slightly. BP in the PHT group was significantly lower during the low Na/high K than during the high Na diet (systolic 10.5 mm Hg +/- 2.3 SE; diastolic 11.2 +/- 2.5, the changes being significantly different from those in the PNT group. The changes in plasma renin and aldosterone were similar in both groups during the different diets. Plasma noradrenaline fell in the PHT group, but rose in the PNT group when the low Na diet was supplemented with potassium. This fall in plasma noradrenaline in the PHT group during the low Na/high K diet correlated with the falls in systolic and diastolic BP. It is concluded that whereas young adults with a familial predisposition to hypertension behave similarly to those without such a predisposition in having a pressor response to a high sodium intake, they are peculiar in showing a depressor response to a high potassium intake.

In five patients with resistant heart failure treated with the oral converting-enzyme inhibitor, captopril, standardised and intensive haemodynamic, hormone, and electrolyte monitoring showed significantly raised cardiac output and reduced arterial, pulmonary-wedge, and pulmonary-artery pressures which correlated closely with concomitant alterations in the activity of the renin-angiotensin system. These changes occurred in the absence of a natriuresis or diuresis. Clinical improvement was dramatic and paralleled the objective haemodynamic changes. Hyponatraemia and a rise in plasma-potassium were noted. Captopril is a major advance in the treatment of resistant heart failure, and its beneficial haemodynamic effects relate primarily to a blockade of the renin-angiotensin system, the activity of which is increased by conventional drug therapy.

Artificial lung surfactant prepared with pure dipalmitoylphosphatidylcholine and phosphatidylglycerol in a ratio of 7:3 was made as a dry powder and then blown down an endotracheal tube into the lungs of 22 very premature babies at birth. Only one dose was given. The treated babies did better than their 33 controls. Fewer needed ventilation, and those who did required lower pressures in the first six hours of life. None of the treated babies died, compared with 8 of the controls.

In a double-blind randomised trial in 75 patients with duodenal ulceration diagnosed endoscopically, 38 patients were given tripotassium dicitrato bismuthate and 37 cimetidine. There was no significant difference in the healing rates between the two drugs after 1 and 2 months, although relief of symptoms was marginally quicker with cimetidine. During follow-up for at least a year, relapse was significantly more common in patients whose ulcers had healed during treatment with cimetidine than in those whose ulcers had healed during treatment with tripotassium dicitrato bismuthate. This difference appears to be related to the medication rather than to any other difference between the two groups of patients. These results suggest that drug treatment given for a short period in duodenal-ulcer disease influences the progress of the disease.

The duodenal ulcer healing and relapse rates reported in studies of short-term and long-term treatment with cimetidine or placebo have been used to predict the results of three treatment strategies. By far the greatest benefit of cimetidine is obtained when the drug is given as continuous low-dose maintenance therapy, with a full-dose at times of relapse.

An attempt was made to control schistosomiasis mansoni with mass treatment of all subjects excreting more than 100 eggs/g of faeces. No other means of control to reduce transmission were used. A very low dosage of hycanthone (0.75 mg/kg) appeared insufficient to achieve a satisfactory reduction of the worm load. A higher dosage (1.5 mg/kg) resulted in a significant reduction of the egg output. However, reappearance of eggs, probably indicating reinfection, was very rapid. One year after treatment the egg counts were at about two-thirds of the original level again.

In a randomised cross-over study 18 nondependent (NIDDM) and 9 insulin-dependent (IDDM) diabetics were put on to a high carbohydrate diet containing leguminous fibre (HL) for 6 weeks, and also a standard low carbohydrate diet (LC) for 6 weeks. During two identical 24 h metabolic profiles mean preprandial and mean 2 hour postprandial blood glucoses were significantly lower on HL in both groups, as were also several overall measures of diabetic control, including the degree of glycosuria. Total cholesterol was reduced significantly on HL in both groups, and the HDL/LDL cholesterol ratio increased significantly on HL in the NIDDM group. A diet high in complex carbohydrate and leguminous fibre improves all aspects of diabetic control, and continued use of a low carbohydrate diet no longer appears justified.