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Fig. 1 Life-cycle of the tapeworm Echinococcus.

Endocarditis is a relatively frequent infection in intravenous drug users. We compared features in the cases of 102 patients with those in intravenous drug users with other causes of fever to identify risk factors predictive of endocarditis. Logistic regression analysis showed cocaine use to be strongly associated with endocarditis. This special risk involving cocaine use has not been reported previously; the explanation for it may provide insight into the pathogenesis of endocarditis.

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Summary Histamine has recently been shown to be a growth factor for some gastric and colorectal cancer cells. Previous studies have shown that cimetidine blocks in vitro and in vivo histamine-stimulated growth and cAMP release from the human colonic cancer cell line, C170. In this study, ranitidine, another H2 receptor antagonist, did not affect either basal or histamine-stimulated in vitro proliferation of C170, and failed to prevent cAMP release in vitro. Ranitidine did not inhibit in vivo growth of C170 at a dose of 1, 10, 25, 50 or 100 mg kg-', in contrast to 50 mg kg -day-' cimetidine, which produced 39.3% inhibition of tumour volume (P<0.01) after 23 days' treatment. Ranitidine did not inhibit in vivo histamine-stimulated growth of C170 cells.LIM2412, another colonic cancer cell line, was significantly stimulated by both cimetidine and ranitidine in vivo. Ranitidine had no effect on in vitro cell proliferation.

One hundred patients were entered in a randomized, controlled study of adjuvant tamoxifen therapy in gastric carcinoma. Estrogen receptor status was established by an immunohistologic method (ERD5) and 55.8% of the tumors were positive. Tamoxifen had no overall effect on survival, but there was a significant decrease in the survival time of the patients with ERD5-positive tumors. Estrogen receptor status (by the ERD5 method) is an independent prognostic factor in gastric cancer. Tamoxifen therapy does not prolong survival, and new therapeutic strategies require investigation.

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