SUMMARY Of 29 524 hospitalised medical patients monitored in a drug surveillance programme 1835 (6 2 %) received the xanthine oxidase inhibitor allopurinol. After the exclusion of skin reactions adverse effects were attributed to this drug in 33 (1.8 %) patients, the most frequent being haematological abnormalities (11 patients, 0 6 %) and diarrhoea and drug fever (5 each, 0 3 %). Adverse effects were dose-related. Reactions were unrelated to age, weight, reason for therapy, admission blood urea, or albumin concentrations. Acute exacerbation of gout was troublesome in 3 patients (1 in 600 exposed).Allopurinol achieves its major pharmacological effect through inhibition of the enzyme xanthine oxidase. The resultant alterations in purine metabolism explain its effectiveness in the treatment both of idiopathic gout and of hyperuricaemia secondary to blood dyscrasias, antineoplastic chemotherapy, and diuretic therapy

Fecal energy (FE) loss was measured using bomb calorimetry in 30 patients; 14 had a history of malabsorption, while 16 had no history of intestinal dysfunction. Average digestibility (and range) of energy and FE loss were 73% (48 to 91%) and 493 kcal/day (177 to 927 kcal/day) in the group with malabsorption, compared to 96% (89 to 99%) and 74 kcal/day (8 to 146 kcal/day) in the group without malabsorption, respectively. Metabolizable energy supplied by the diet (intake kcal -- (fecal kcal + urinary kcal) was below the calculated daily energy requirement in five of seven patients with malabsorption; in three of these five subjects the combination of decreased energy intake and increased FE loss produced negative energy balance, while in the remaining two patients malabsorption alone caused negative energy balance. Inadequate metabolizable energy in these five patients was associated with weight loss and protein-energy malnutrition. The usual clinical laboratory tests applied to the study of malabsorption, including fecal fat, fecal nitrogen, and stool weight, were poor predictors of FE loss. These tests were also of limited value in assessing the effects of dietary modification on energy malabsorption. Contrastingly, bomb calorimetry provided a simple and accurate alternative in quantitatively assessing FE loss in the patient with malabsorption.

1. Iron metabolism has been investigated in patients suffering from chronic renal 2. Absorption of labelled inorganic iron was decreased. 3. Radio-iron was lost from the body at a rate comparable to that found in normal 4. The red cell incorporation of radioactive iron was diminished. 5. The results suggest that anaemia in these patients was due to decreased erythropoiesis and not due to iron deficiency despite the evidence of markedly abnormal iron handling presented.

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