In a randomised clinical trial to assess the value of intestinal bypass in the treatment of gross obesity 130 patients who underwent end-to-side jejunoileostomy (with either a 1/3 or a 3/1 ratio between jejunum and ileum left in continuity) were compared with 66 non-surgically treated patients. All patients in the study had gross, long-standing, treatment-resistant obesity with resultant somatic, psychic, or social problems; none were alcoholic or had liver disease or other conditions which made them poor surgical risks. Most subjects were observed for more than 3 years. Median weight loss within 24 months was 42.9 kg in the bypass group, compared with 5.9 kg in the control group. No deaths occurred among those who underwent surgery. Patients who underwent intestinal bypass also had a better improvement in quality of life and a higher degree of patient satisfaction. Complications of the operation were, however, common and occasionally severe.

In a double-blind trial patients with Argentine haemorrhagic fever treated with immune plasma within 8 days of the onset of the disease had a much lower mortality than those given normal plasma. Some patients treated with immune plasma developed late neurological complications.

The clinical efficacy of using specially trained nurses to treat hypertension at the patient's place of work was compared in a controlled trial with management by the patient's family doctor. The 457 study participants were selected from 21 906 volunteers in industry and government whose blood-pressure was screened. The nurses were allowed to prescribe and change drug therapy at the work site without prior physician approval. Patients randomly allocated to receive care at work were significantly more likely to be put on antihypertensive medications (94.7% vs 62.7%, to reach goal blood-pressure in the first six months (48.5% vs 27.5%), and to take the drugs prescribed (67.6% vs 49.1%). Only 6% of patients were dissatisfied with the care provided by the nurses. Thus provision of care at work by specially tranined nurses was well accepted and resulted in significantly improved blood-pressure control and medication compliance among employees with asymptomatic and uncomplicated hypertension.

In a double-blind, cross-over study of twenty male volunteers intravenous injection of 0.4 mg naloxone prevented the impairment of psychomotor performance induced by low levels of blood alcohol. The possibility that alcohol produces intoxication by stimulating the release of endogenous opioid peptides should be investigated.

Motor performance of children born to mothers living in an iodine-deficient region was assessed. The mothers were participants in a controlled trial of intramuscular iodised oil in the prevention of endemic cretinism carried out in the Western Highlands of Papua New Guinea. Mothers received either iodised oil or placebo saline. Children born to mothers given iodine were significantly faster and more accurate in tests of manual function than children from control mothers. The findings indicate that iodine deficiency may lead to a spectrum of subclinical deficits which place the children at a developmental disadvantage.