- Email: [email protected]
BIRTH OF A COLLEGE
1409
Hospital in Hampstead. Subsequently, a large number of hospital personnel were taken ill and the hospital was forced to close for over two months. Similar episodes were noted in the same year in Dalston, Cumbria, and Durban, South Africa, and over fifty outbreaks have now been documented in various parts of the world. In retrospect, an outbreak of what was at first thought to be poliomyelitis in Los Angeles in 1934 may be another example. Dr Melvin Ramsay, one of the pioneers in the investigation of the first recognised outbreak has now written a monograph on the subject.’ Characteristic features of the illness include low-grade fever, headache, blurred vision and/or diplopia, stiff neck, vertigo with a
positive Romberg test, nausea and/or vomiting, lymphadenopathy, lower costal or generalised muscle weakness unrelieved by rest, emotional lability, insomnia and/or vivid dreams often in colour, frequency or retention of urine, and varying degrees of deafness or hyperacusis. In most cases there is a history of a respiratory or gastrointestinal infection, but instead of an uneventful recovery the patient suffers from persistent and profound fatigue accompanied by some of the above-mentioned symptoms. Muscle fatiguability is the dominant and most persistent feature of the disease,and the diagnosis should not be entertained without it. It is perhaps regrettable that the term myalgic encephalomyelitis has been adopted in Britain in the absence of histological proof of brain inflammation, but earlier attempts to attribute the disorder to mass hysteria are clearly untenable, as Dr Ramsay points out, when there is firm evidence of physical disease with relapse and chronic morbidity. The most likely explanation is that the illness represents an abnormal response to various "trigger" viruses such as Epstein-Barr virus, Coxsackie group B viruses, and subacute myelo-optic neuropathy (SMON) virus. There is no established treatment, although the effects of immunoglobulins and the anti-viral agent inosine pranobex are under investigation. Meanwhile, patients can be advised to adjust to a quieter tempo of life if possible and to be sure to take adequate periods of rest after physical exertion. In Britain, the ME Association has been of great assistance to patients by introducing them to others similarly afflicted and by disseminating information. As Dr Ramsey comments "victims of ME should no longer have to dread the verdict ’All your tests are normal. Therefore there is nothing wrong with ’
you’." WE NEED STANDARDS
THE National Institute for Biological Standards and Control is primarily responsible for ensuring that all biological medicinal products intended for human use in the UK are of acceptable purity, potency, and safety. Stable biological standards are prepared by the Institute in large batches of identical ampoules--one standard usually consists of 3000-4000 ampoules-and allocated an agreed unitage of biological activity. Apart from the day-to-day "control" work, the various divisions at NIBSC play an important role in basic research allied to their responsibilities. The latest NIBSC annual report2 highlights the wide range of activities. 1984-85 witnessed, among other things, testing of heat-treated factor VIII (to inactivate non-A, non-B hepatitis virus and HIV) heated for potentcy and antigenicity and research into a factor VIII/phospholipid complex which might hold promise in the treatment of haemophiliacs who have factor VIII antibodies. The Antibiotics and Chemistry Division reported progress in the application of high-field magnetic resonance to elucidate the structure of two of the polysaccharides in pneumococcal vaccine; the Hormones Division conducted research into refractoriness of Paget’s disease of bone to salmon calcitonin treatment and into the chemical and biological variability of corticotropic peptides; and the Viral Products Division investigated the molecular basis for hepatitis A virus virulence which is relevant to standardisation and control of commercial hepatitis A vaccines. Overall, the report notes that the work of the Institute is becoming
(NIBSC)
1.
2.
Ramsay AM. Postviral fatigue syndrome The saga of Royal Free disease. 1986. Pp 64. £3.50 plus 50p postage and packing from the Myalgic Encephalomyelitis Association, PO Box 8, Stanford le Hope, Essex SS17 8EX. National Institute for Biological Standards and Control. Report for 1st April 1984 to 31st March 1985. NIBSC, Holly Hill, Hampstead, London NW3 6RB.
more
oriented towards molecular
biology
and recombinant DNA
techniques. ACHIEVING A BALANCE LACK of a structured career in hospital medicine has caused many young doctors to specialise in general practice with the result that many health authorities are experiencing severe difficulties in recruiting senior house-officers. In turn this has meant a dearth of senior doctors providing inpatient care. Achieving a Balance is a document published by the Government containing proposals intended to restore the hospital medical staffing structure over the next 10 years. A question and answer outline of the document has been circulated by the British Medical Association. The existing rate of consultant expansion is about 2 %. The report proposes the closure of registrar and senior registrar posts to free funds for the creation of a number of new consultant posts and the creation within two years of 50 new consultant posts each in the medical and surgical specialties. These measures will expand the consultant grade to 22 300 posts by the year 2000, an increase of 37 % over the 1985 figure. The National Association of Health Authorities welcomes1 the expansion of consultant posts but does not agree that they should be restricted to the acute specialties when greater needs exist elsewhere in the health service. The proposals also underestimate the financial cost of such an exercise.
BIRTH OF A COLLEGE THE first president and the major architect of the Royal College of Obstetricians and Gynaecologists wasa determined man and a very difficult one. In a short memoir2 one of Prof William Blair-Bell’s heirs to the presidential mantle (the original robe was buried with him) does not shirk from relating some of Blair-Bell’s pettier actions. Contemporaneous obituaries were in the nisi bonum tradition. Had its founder not been so single-minded the College might never have been born, so strong was the opposition in London’s obstetric circles and in the physicians’ and surgeons’ colleges. However, it is strange that Blair-Bell got on so badly with some of those who shared his ambitions for the specialty. In his will he combined generosity with pique, laying down Byzantine conditions that were to haunt the beneficiary College for forty years. Sir John Peel draws on Blair-Bell’s own unfinished history that had to be sealed for twenty years and then turned out to be not publishable. British obstetricians and gynaecologists will welcome Sir John’s honest and succinct assessment. At the same time they may wonder how Blair-Bell’s lead treatment for breast cancer, though monitored by a scientific committee, survived for so long to a total of 566 cases. Discussion of it in the 1920s was surprisingly vigorous. Sir John’s notion that professional infighting of the sort recorded here has now passed away will raise an eyebrow. International War
Physicians for the Prevention of Nuclear
The 7th world congress of IPPNW will be held in Moscow, to June 1, 1987.3 The regional Asian Pacific congress will be held in Auckland, NZ, on Feb 9-10, 1987 .4 IPPNW, which represents over 150 000 physicians and related health scientists from 50 countries, seeks to encourage research in the prevention of nuclear war. Such research might encompass the disciplines of sociology, economics, psychology, education, and . political science. A session at the annual meeting will be devoted to the presentation of current research.5
USSR, from May 29
Hospital Medical Staffing: Achieving a Balance. NAHA’s Response. Available from the National Association of Health Authorities, Earth House, Edgbaston Road, Birmingham B15 2RS (021-471 4444) 2. William Blair-Bell: Father and Founder. By Sir John Peel. London: Royal College of Obstetricans and Gynaecologists. 1986. Pp 89 £6 (plus £1 for postage and packing). 3. Information from Organising Committee, Solianka 14, Moscow 109801, USSR. 4. Information from Dr Ian Prior, IPPNW NZ, Wellington Hospital, Wellington, New 1
Zealand. 5. 300-word abstracts should be sent to International Research 225 Longwood Avenue, Boston, MA 02115, USA.
Programme, IPPNW,
1410 Medical
Campaign against Nuclear Weapons
A copy of the membership list of MCANW, stored on floppy discs, has disappeared from the Campaign’s national office in London. No other items were removed. The executive committee has told all 3500 members of MCANW of the loss. The letter to members includes this sentence: "Although the disappearance of the discs may have been a casual theft, there is a distinct possibility that these particular discs were taken by some organisation or body that would have an interest in our membership list". Access to Medical Records A Private Member’s Bill to allow access to personal files, including school records, social services records, employment files, and medical records, has come sixth in the ballot for debate and therefore stands a chance of becoming law before the next general election. The Bill, introduced by Mr Archy Kirkwood, MP (SDP/All), has all-party support from about 150 MPs, including 60 Conservatives. The Bill has the support of the Campaign for Freedom of Information and seeks to eliminate the inconsistency of the Data Protection Act, which allows access to computerised records but not to written records. Lord Rae, a general practitioner and member of the House of Lords, has described in the House some of the difficulties encountered by doctors who wish to show patients their records. Nevertheless, Lord Rae believes that most doctors are in favour of open records, which can inspire greater trust between both parties and encourage accuracy and objectivity.
Royal College of Nursing Guidance on AIDS and Hepatitis B A strongly worded preface to the new set of guidelines1 on nursing patients with AIDS emphasises the responsibility of all nurses to offer appropriate care to the sick: "There is no ’opt-out’ clause for caring for patients with AIDS/HIV related diseases, and refusal to care may well result in disciplinary procedures being taken against the nurse for unprofessional conduct." Stringent infection control procedures aim to protect the nurse from accidental infection. The College is also urging all nurses to seek vaccination against hepatitis B and is calling on the Government to offer the vaccine routinely to all nurses. At present it is offered only to nurses working with high risk groups, such as renal patients, but the risk is present in exposure to many other groups, such as children with Down syndrome. Sexual Abuse of Children The Training Advisory Group on the Sexual Abuse of Children, with support from the Department of Health and in collaboration with the National Children’s Bureau, hopes to provide a training advisory resource in child sexual abuse. Tasks will include the provision of an advisory/consultancy service on training or organisational issues and the compilation and maintenance of a data base of information on child abuse. Contact: Prof Sydney Brandon, Leicester Royal Infirmary, Leicester LE2 7LX.
Availability of Intrauterine Devices The multinational pharmaceutical company, G. D. Searle, has ceased production of two IUDs, the copper 7 (’Gravigard’) and the ’Minigravigard’, and is debating the future of the ’Novagard’. These products comprise about two-thirds of the UK market leaving about six other devices available. According to the Family Planning Association, the safety and efficacy of the IUD is not in question, but the large number of legal cases brought against manufacturers of contraceptive and other medical products in the United States has caused many manufacturers to cease production. The IUD is now virtually unobtainable in America. In the UK, the IUD is the fourth most widely used method of birth control after the pill, male and female sterilisation, and condoms. The World Health Organisation is to produce a technical report on the value of IUDs. World Health Organisation Dr Wilfred Kreisel, who has been regional adviser on environmental health at the WHO regional office for the Western Pacific, Manila, has been appointed director of the division of environmental health in Geneva. Dr Kreisel, who is from West Germany, succeeds Dr Bernd Dieterich. Down in the Mouth is a new leaflet, produced by the Health Education Council and the Scottish Health Education Group, warning of the dangers of tobacco pouches. Tobacco pouches can increase the risk of cancer of the mouth, cause dependence on nicotine, and cause the gums to recede. ’Skoal Bandits’ are available in Britain and sold in small round containers of 20. They are manufactured in Scotland and do not carry a health warning.
Applications are invited for the Takemi fellowships in international health. An interdisciplinary programme focuses on mobilising, allocating, and managing scarce resources to improve health, particularly in developing countries, and on creating sound strategies for disease control and health promotion. Further information is available from Prof L. C. Chen, Director, Takemi Program in International Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. Nominations are invited for the 1987 award of the Society for Drug Research for drug discovery. The award recognises outstanding research leading to drug discovery and is open to scientists of British nationality or living in Britain. Details are available from Dr J. D.Flack, Hon Secretary, Society for Drug Research, Beecham Pharmaceuticals, Honeypot Lane,
Stock, Essex CM4 9PE.
Applications are invited for support of research projects or development proposals concerned with nutrition and diabetes. Areas of particular interest are exploration of new dietary principles, their acceptability to patients, problems of teaching, and metabolic response: British Diabetic Association, 10 Queen Anne Street, London. Aesculapius is a recently established business owned by a physician and devoted to medical antiques. Competitive prices are offered for all medical artefacts dated before 1920 and a free illustrated catalogue may be obtained from Aesculapius, PO Box 85, Portsmouth P06 2BB, Hampshire. RevIsed NTotice.-A meeting on Antiviral Chemotherapy will take place the School of Pharmacy, London WC1, on Tuesday, Dec 16: Society for Drug Research, c/o Institute of Biology, 20 Queensberry Place, London SW7 2DZ (01-581 8333). at
Early Detection of Cancer A report from the American Council on Science and Health discusses the benefits and risks of screening for cancer and urges: annual breast examination and mammography for women aged over 50; cervical smear tests every three years in women over the age of 20 after two negative tests have been recorded one year apart (younger sexually active women should also have smears); and occult blood testing annually and flexible sigmoidoscopy every three years in both sexes over the age of 50. Routine chest X rays are not recommended as a screening test for lung cancer. booklet, entitled Cancer Screening: What You Can Do to Detect Cancer, is available from the Amencan Council on Science and Health, 47 Maple Street, Summit, NJ 07901, USA. The
1.
Nursing Guidelines on the Mangement of Patients in Hospital and the Community Suffering from AIDS. Available from the Royal College of Nursing, 20 Cavendish Square, London W1M 0AB
Diary of the Week DEC
Monday,
14 TO 19
15th
ST GEORGE’S HOSPITAL MEDICAL SCHOOL, 3rd Floor, Lanesborough Wmg, Cranmer Terrace, London SWI7 ORE 12-30 pm Dr A Grant. Matenals and Techniques for Penneal Repair-Is the Choice Consistent with Evidence from Clinical Research?
Tuesday, 16th ENDOCRINE CLUB, St Bartholomew’s Hospital, Robm Brook Centre, West Srmthfield, London ECIA 7BE 5 30 pm Dr E Marelyn Winter (Melbourne) Function and Regulation of the Adrenal Cortex of the Ovne Fetus
Wednesday, 17th MANCHESTER MEDICAL SOCIETY, John Rylands Universirv Library, Oxford Road, Manchester M13 9PP 2 pm Dr E Tapp. St Bees Man-Did He Fall or Was He Pushed? Mr R NeaB e. Heads and Tales.
Hospital in Hampstead. Subsequently, a large number of hospital personnel were taken ill and the hospital was forced to close for over two months. Similar episodes were noted in the same year in Dalston, Cumbria, and Durban, South Africa, and over fifty outbreaks have now been documented in various parts of the world. In retrospect, an outbreak of what was at first thought to be poliomyelitis in Los Angeles in 1934 may be another example. Dr Melvin Ramsay, one of the pioneers in the investigation of the first recognised outbreak has now written a monograph on the subject.’ Characteristic features of the illness include low-grade fever, headache, blurred vision and/or diplopia, stiff neck, vertigo with a
positive Romberg test, nausea and/or vomiting, lymphadenopathy, lower costal or generalised muscle weakness unrelieved by rest, emotional lability, insomnia and/or vivid dreams often in colour, frequency or retention of urine, and varying degrees of deafness or hyperacusis. In most cases there is a history of a respiratory or gastrointestinal infection, but instead of an uneventful recovery the patient suffers from persistent and profound fatigue accompanied by some of the above-mentioned symptoms. Muscle fatiguability is the dominant and most persistent feature of the disease,and the diagnosis should not be entertained without it. It is perhaps regrettable that the term myalgic encephalomyelitis has been adopted in Britain in the absence of histological proof of brain inflammation, but earlier attempts to attribute the disorder to mass hysteria are clearly untenable, as Dr Ramsay points out, when there is firm evidence of physical disease with relapse and chronic morbidity. The most likely explanation is that the illness represents an abnormal response to various "trigger" viruses such as Epstein-Barr virus, Coxsackie group B viruses, and subacute myelo-optic neuropathy (SMON) virus. There is no established treatment, although the effects of immunoglobulins and the anti-viral agent inosine pranobex are under investigation. Meanwhile, patients can be advised to adjust to a quieter tempo of life if possible and to be sure to take adequate periods of rest after physical exertion. In Britain, the ME Association has been of great assistance to patients by introducing them to others similarly afflicted and by disseminating information. As Dr Ramsey comments "victims of ME should no longer have to dread the verdict ’All your tests are normal. Therefore there is nothing wrong with ’
you’." WE NEED STANDARDS
THE National Institute for Biological Standards and Control is primarily responsible for ensuring that all biological medicinal products intended for human use in the UK are of acceptable purity, potency, and safety. Stable biological standards are prepared by the Institute in large batches of identical ampoules--one standard usually consists of 3000-4000 ampoules-and allocated an agreed unitage of biological activity. Apart from the day-to-day "control" work, the various divisions at NIBSC play an important role in basic research allied to their responsibilities. The latest NIBSC annual report2 highlights the wide range of activities. 1984-85 witnessed, among other things, testing of heat-treated factor VIII (to inactivate non-A, non-B hepatitis virus and HIV) heated for potentcy and antigenicity and research into a factor VIII/phospholipid complex which might hold promise in the treatment of haemophiliacs who have factor VIII antibodies. The Antibiotics and Chemistry Division reported progress in the application of high-field magnetic resonance to elucidate the structure of two of the polysaccharides in pneumococcal vaccine; the Hormones Division conducted research into refractoriness of Paget’s disease of bone to salmon calcitonin treatment and into the chemical and biological variability of corticotropic peptides; and the Viral Products Division investigated the molecular basis for hepatitis A virus virulence which is relevant to standardisation and control of commercial hepatitis A vaccines. Overall, the report notes that the work of the Institute is becoming
(NIBSC)
1.
2.
Ramsay AM. Postviral fatigue syndrome The saga of Royal Free disease. 1986. Pp 64. £3.50 plus 50p postage and packing from the Myalgic Encephalomyelitis Association, PO Box 8, Stanford le Hope, Essex SS17 8EX. National Institute for Biological Standards and Control. Report for 1st April 1984 to 31st March 1985. NIBSC, Holly Hill, Hampstead, London NW3 6RB.
more
oriented towards molecular
biology
and recombinant DNA
techniques. ACHIEVING A BALANCE LACK of a structured career in hospital medicine has caused many young doctors to specialise in general practice with the result that many health authorities are experiencing severe difficulties in recruiting senior house-officers. In turn this has meant a dearth of senior doctors providing inpatient care. Achieving a Balance is a document published by the Government containing proposals intended to restore the hospital medical staffing structure over the next 10 years. A question and answer outline of the document has been circulated by the British Medical Association. The existing rate of consultant expansion is about 2 %. The report proposes the closure of registrar and senior registrar posts to free funds for the creation of a number of new consultant posts and the creation within two years of 50 new consultant posts each in the medical and surgical specialties. These measures will expand the consultant grade to 22 300 posts by the year 2000, an increase of 37 % over the 1985 figure. The National Association of Health Authorities welcomes1 the expansion of consultant posts but does not agree that they should be restricted to the acute specialties when greater needs exist elsewhere in the health service. The proposals also underestimate the financial cost of such an exercise.
BIRTH OF A COLLEGE THE first president and the major architect of the Royal College of Obstetricians and Gynaecologists wasa determined man and a very difficult one. In a short memoir2 one of Prof William Blair-Bell’s heirs to the presidential mantle (the original robe was buried with him) does not shirk from relating some of Blair-Bell’s pettier actions. Contemporaneous obituaries were in the nisi bonum tradition. Had its founder not been so single-minded the College might never have been born, so strong was the opposition in London’s obstetric circles and in the physicians’ and surgeons’ colleges. However, it is strange that Blair-Bell got on so badly with some of those who shared his ambitions for the specialty. In his will he combined generosity with pique, laying down Byzantine conditions that were to haunt the beneficiary College for forty years. Sir John Peel draws on Blair-Bell’s own unfinished history that had to be sealed for twenty years and then turned out to be not publishable. British obstetricians and gynaecologists will welcome Sir John’s honest and succinct assessment. At the same time they may wonder how Blair-Bell’s lead treatment for breast cancer, though monitored by a scientific committee, survived for so long to a total of 566 cases. Discussion of it in the 1920s was surprisingly vigorous. Sir John’s notion that professional infighting of the sort recorded here has now passed away will raise an eyebrow. International War
Physicians for the Prevention of Nuclear
The 7th world congress of IPPNW will be held in Moscow, to June 1, 1987.3 The regional Asian Pacific congress will be held in Auckland, NZ, on Feb 9-10, 1987 .4 IPPNW, which represents over 150 000 physicians and related health scientists from 50 countries, seeks to encourage research in the prevention of nuclear war. Such research might encompass the disciplines of sociology, economics, psychology, education, and . political science. A session at the annual meeting will be devoted to the presentation of current research.5
USSR, from May 29
Hospital Medical Staffing: Achieving a Balance. NAHA’s Response. Available from the National Association of Health Authorities, Earth House, Edgbaston Road, Birmingham B15 2RS (021-471 4444) 2. William Blair-Bell: Father and Founder. By Sir John Peel. London: Royal College of Obstetricans and Gynaecologists. 1986. Pp 89 £6 (plus £1 for postage and packing). 3. Information from Organising Committee, Solianka 14, Moscow 109801, USSR. 4. Information from Dr Ian Prior, IPPNW NZ, Wellington Hospital, Wellington, New 1
Zealand. 5. 300-word abstracts should be sent to International Research 225 Longwood Avenue, Boston, MA 02115, USA.
Programme, IPPNW,
1410 Medical
Campaign against Nuclear Weapons
A copy of the membership list of MCANW, stored on floppy discs, has disappeared from the Campaign’s national office in London. No other items were removed. The executive committee has told all 3500 members of MCANW of the loss. The letter to members includes this sentence: "Although the disappearance of the discs may have been a casual theft, there is a distinct possibility that these particular discs were taken by some organisation or body that would have an interest in our membership list". Access to Medical Records A Private Member’s Bill to allow access to personal files, including school records, social services records, employment files, and medical records, has come sixth in the ballot for debate and therefore stands a chance of becoming law before the next general election. The Bill, introduced by Mr Archy Kirkwood, MP (SDP/All), has all-party support from about 150 MPs, including 60 Conservatives. The Bill has the support of the Campaign for Freedom of Information and seeks to eliminate the inconsistency of the Data Protection Act, which allows access to computerised records but not to written records. Lord Rae, a general practitioner and member of the House of Lords, has described in the House some of the difficulties encountered by doctors who wish to show patients their records. Nevertheless, Lord Rae believes that most doctors are in favour of open records, which can inspire greater trust between both parties and encourage accuracy and objectivity.
Royal College of Nursing Guidance on AIDS and Hepatitis B A strongly worded preface to the new set of guidelines1 on nursing patients with AIDS emphasises the responsibility of all nurses to offer appropriate care to the sick: "There is no ’opt-out’ clause for caring for patients with AIDS/HIV related diseases, and refusal to care may well result in disciplinary procedures being taken against the nurse for unprofessional conduct." Stringent infection control procedures aim to protect the nurse from accidental infection. The College is also urging all nurses to seek vaccination against hepatitis B and is calling on the Government to offer the vaccine routinely to all nurses. At present it is offered only to nurses working with high risk groups, such as renal patients, but the risk is present in exposure to many other groups, such as children with Down syndrome. Sexual Abuse of Children The Training Advisory Group on the Sexual Abuse of Children, with support from the Department of Health and in collaboration with the National Children’s Bureau, hopes to provide a training advisory resource in child sexual abuse. Tasks will include the provision of an advisory/consultancy service on training or organisational issues and the compilation and maintenance of a data base of information on child abuse. Contact: Prof Sydney Brandon, Leicester Royal Infirmary, Leicester LE2 7LX.
Availability of Intrauterine Devices The multinational pharmaceutical company, G. D. Searle, has ceased production of two IUDs, the copper 7 (’Gravigard’) and the ’Minigravigard’, and is debating the future of the ’Novagard’. These products comprise about two-thirds of the UK market leaving about six other devices available. According to the Family Planning Association, the safety and efficacy of the IUD is not in question, but the large number of legal cases brought against manufacturers of contraceptive and other medical products in the United States has caused many manufacturers to cease production. The IUD is now virtually unobtainable in America. In the UK, the IUD is the fourth most widely used method of birth control after the pill, male and female sterilisation, and condoms. The World Health Organisation is to produce a technical report on the value of IUDs. World Health Organisation Dr Wilfred Kreisel, who has been regional adviser on environmental health at the WHO regional office for the Western Pacific, Manila, has been appointed director of the division of environmental health in Geneva. Dr Kreisel, who is from West Germany, succeeds Dr Bernd Dieterich. Down in the Mouth is a new leaflet, produced by the Health Education Council and the Scottish Health Education Group, warning of the dangers of tobacco pouches. Tobacco pouches can increase the risk of cancer of the mouth, cause dependence on nicotine, and cause the gums to recede. ’Skoal Bandits’ are available in Britain and sold in small round containers of 20. They are manufactured in Scotland and do not carry a health warning.
Applications are invited for the Takemi fellowships in international health. An interdisciplinary programme focuses on mobilising, allocating, and managing scarce resources to improve health, particularly in developing countries, and on creating sound strategies for disease control and health promotion. Further information is available from Prof L. C. Chen, Director, Takemi Program in International Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. Nominations are invited for the 1987 award of the Society for Drug Research for drug discovery. The award recognises outstanding research leading to drug discovery and is open to scientists of British nationality or living in Britain. Details are available from Dr J. D.Flack, Hon Secretary, Society for Drug Research, Beecham Pharmaceuticals, Honeypot Lane,
Stock, Essex CM4 9PE.
Applications are invited for support of research projects or development proposals concerned with nutrition and diabetes. Areas of particular interest are exploration of new dietary principles, their acceptability to patients, problems of teaching, and metabolic response: British Diabetic Association, 10 Queen Anne Street, London. Aesculapius is a recently established business owned by a physician and devoted to medical antiques. Competitive prices are offered for all medical artefacts dated before 1920 and a free illustrated catalogue may be obtained from Aesculapius, PO Box 85, Portsmouth P06 2BB, Hampshire. RevIsed NTotice.-A meeting on Antiviral Chemotherapy will take place the School of Pharmacy, London WC1, on Tuesday, Dec 16: Society for Drug Research, c/o Institute of Biology, 20 Queensberry Place, London SW7 2DZ (01-581 8333). at
Early Detection of Cancer A report from the American Council on Science and Health discusses the benefits and risks of screening for cancer and urges: annual breast examination and mammography for women aged over 50; cervical smear tests every three years in women over the age of 20 after two negative tests have been recorded one year apart (younger sexually active women should also have smears); and occult blood testing annually and flexible sigmoidoscopy every three years in both sexes over the age of 50. Routine chest X rays are not recommended as a screening test for lung cancer. booklet, entitled Cancer Screening: What You Can Do to Detect Cancer, is available from the Amencan Council on Science and Health, 47 Maple Street, Summit, NJ 07901, USA. The
1.
Nursing Guidelines on the Mangement of Patients in Hospital and the Community Suffering from AIDS. Available from the Royal College of Nursing, 20 Cavendish Square, London W1M 0AB
Diary of the Week DEC
Monday,
14 TO 19
15th
ST GEORGE’S HOSPITAL MEDICAL SCHOOL, 3rd Floor, Lanesborough Wmg, Cranmer Terrace, London SWI7 ORE 12-30 pm Dr A Grant. Matenals and Techniques for Penneal Repair-Is the Choice Consistent with Evidence from Clinical Research?
Tuesday, 16th ENDOCRINE CLUB, St Bartholomew’s Hospital, Robm Brook Centre, West Srmthfield, London ECIA 7BE 5 30 pm Dr E Marelyn Winter (Melbourne) Function and Regulation of the Adrenal Cortex of the Ovne Fetus
Wednesday, 17th MANCHESTER MEDICAL SOCIETY, John Rylands Universirv Library, Oxford Road, Manchester M13 9PP 2 pm Dr E Tapp. St Bees Man-Did He Fall or Was He Pushed? Mr R NeaB e. Heads and Tales.