Several small studies have indicated that the systemic administration of pentoxifylline may accelerate healing of venous leg ulcers. The goal of this study was to further evaluate these findings in a larger scale placebo controlled trial and to explore the effect of the dose of pentoxifylline on healing. The study used a prospective, randomized, double-blind, parallel group placebo controlled design in a multicenter outpatient setting. Patients with one or more venous ulcer were enrolled, with all patients receiving standardized compression bandaging for treatment for their ulcers. Patients were also randomized to receive either pentoxifylline 400 mg, pentoxifylline 800 mg (two 400 mg tablets), or placebo tablets three times a day for up to 24 weeks. The main outcome measure was time to complete healing of all leg ulcers, using life table analysis. The study was completed as planned in 131 patients. Patients receiving 800 mg three times a day of pentoxifylline healed faster than placebo (p = 0.043, Wilcoxon test). The median time to complete healing was 100, 83, and 71 days for placebo, pentoxifylline 400 mg, and pentoxifylline 800 mg three times a day, respectively. Over half of all patients were ulcer free at week 16 (placebo) and at week 12 in both pentoxifylline groups. Whereas the placebo group had only achieved complete healing in half of the cases by week 16, all of the subjects remaining in the group receiving the high dose of pentoxifylline had healed completely. Treatment with pentoxifylline was well tolerated with similar drop-out rates in all three treatment groups. Complete wound closure occurred at least 4 weeks earlier in the majority of patients treated with pentoxifylline by comparison to placebo. A higher dose of pentoxifylline (800 mg three times a day) was more effective than the lower dose. We conclude that pentoxifylline is effective in accelerating healing of leg ulcers.

Background: The effect of prophylactic nasal corticosteroids on wheezing episodes associated with colds was investigated in a 12 week parallel group, double blind, randomised controlled trial in preschool children. Methods: Data were collected from 50 children aged 12-54 months with a history of at least three episodes of wheeze associated with colds over the previous winter, but few or no interval symptoms; 24 were given one dose of fluticasone aqueous nasal spray (50 µg) into each nostril twice daily and 26 received an indistinguishable placebo spray. Episodes of lower respiratory illness occurring within 2 days of the onset of a cold were identified from daily symptom diaries. The main outcome was nocturnal symptom score during the first 7 days of an episode. Results: The groups were well balanced on entry except that the treatment group had a history of more prolonged episodes. During the trial there was no significant difference in the number of episodes in the treatment and control groups (27 and 37, respectively), in the severity of nocturnal symptoms (mean score 1.33 and 1.22, respectively, confidence interval of difference -0.24 to +0.47) or in daytime symptoms, activity or total scores during episodes. Compliance was estimated to be over 50% in 43 of the children. Conclusions: Nasal corticosteroid treatment does not prevent acute wheezy episodes associated with upper respiratory infections (common colds) in preschool children.

Summary.— Treatment with azathioprine has been used successfully in 5 cases of widespread PRP. Four cases cleared completely and in the other, after good improvement, treatment was abandoned on account of abdominal pains. Complete clearing may be slow, and treatment needs to be long continued. Two cases remain clear without treatment after 3 years and 2 years respectively. No serious side‐effects have been seen with the doses used.

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Summary Two cases are reported of drug loxicity resulting from the simultancous administration of methotrexate and phenylbutazone. The clinical features were those of methotrexate overdosage. It is postulated that phenylbutazone displaces methotrexate form flasma protein binding sites, thus increasing the free methotrexate concentration. To our knowledge this interaction has not previously been reported.

rash and diarrhoea on November 12 and all drugs were discontinued on November 15. As there had been no improvement, she was admitted to hospital on November 18. On examination she was grossly thyrotoxic, being extremely restless and excitable. The pulse rate was 120 per minute. The whole body was covered with a profuse, red maculo-papular rash. Some of the papules were follicular, but there was no purpura. The mouth and throat were erythematous, with numerous small areas of ulceration. No lymphadenopathy or splenomegaly was present. There was no pyrexia on admission. The white cell count was

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