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SHORTAGE OF RADIOGRAPHERS
53 SHORTAGE OF RADIOGRAPHERS Sirwas glad to" see in your leading article of Dec. 10 the comment : It is certainly going to be hard to supply enough well-trained radiographers to staff fully every X-ray department in the country. And if, as seems very likely, it is impossible without a big increase in their salaries, the money must be provided." Most radiologists have felt for many years that one of the most important factors in the chronic shortage of radiographers has been inadequate remuneration. This has already done considerable harm in handicapping recruitment and causing loss of radiographers from the service. In a recent meeting of the Wessex Association of Radiologists, there was unanimous agreement that considerable increase in salary of the superintendents and senior radiographers was urgently needed. Many senior staff have for years continued in their chosen life’s work in spite of the discouraging conditions of service. The smooth running of an X-ray department and the quality of work produced largely depend on them, and it is becoming increasingly hard to find candidates of the right type. Now that the Adrian Committee have made their report I hope that pressure will be brought upon the Ministry, from as many sources as possible, to act without
further procrastination. X-ray Department, Royal Isle of Wight County Hospital, Ryde.
W. R. R. THURSFIELD.
GONADAL DYSGENESIS (TURNER’S SYNDROME) WITH MALE PHENOTYPE AND XO CHROMOSOMAL CONSTITUTION
SiRj—The case of this condition reported by Dr. Bloise colleagues1 is sufficiently unlike other cases of XO karyotype to raise the question of whether the reduction to 45 chromosomes has resulted from reciprocal translocation between X and Y,with loss of a small centric fragment of Y. Such a translocation could well yield a chromosome that would fit into the 6-12 group and would be expected to yield genitalia of the type displayed by the patient. and his
Department of Anatomy, The Medical School, Newcastle upon Tyne.
JOHN GRAY.
SMOKING AND SCHOOLCHILDREN
SIR,-In his report on the attitude of schoolchildren to smoking, quoted in your columns on Dec. 3 (p. 1240), the health education officer of Middlesex recommends wider publicity and enforcement of the law prohibiting under-16s from purchasing cigarettes. Let us face facts. This law has already been rendered impotent by the triumphal advent of the cigarette-vending machine, which literally any child can use. It is clear that the automatic vendor is here to stay, and enforces a frank and full reappraisal of our preventive policies. Legislation is no answer. Current law is an ass, and to propose fresh legislation (e.g., to illegalise smoking itself under a certain arbitrary age) is to court certain ridicule and make forbidden fruit sweeter still. Are we, then, to leave our children unprotected and uninformed, at a time when we are armed with a mounting mass of evidence of the hazards to health of cigarette-smoking ? Never was a rising generation exposed to grosser temptations. The wares are seductively advertised on all sides; pocket-money is invariably lavish, and the traditional forces of discipline and restraint are being steadily eroded by our pleasure-seeking
society. The
gravity of the problem among schoolchildren is well recognised, yet action has been negligible. If the remedy is to 1.
Bloise, W., de Assis, L. M., Bottura, C., Ferrari, I. Lancet, 1960, ii, 1059.
be found, it is in Mr. Penn’s own field. Only a concerted and urgent effort by all concerned, to decide upon and exploit the best means of propaganda, can hope to reduce the incidence of early addiction. As the report1 of the Joint Tuberculosis Council of Great Britain concludes, " Special efforts should be made to discourage young people from taking up smoking".
Perhaps the Central and Scottish Health Services Council Joint Committee on Health Education will address itself to this problem. We need an active policy, virile publicity, and-above all-a dynamic personal effort from all the members of our profession who have so shamefully neglected their duty to put the facts before the public. ALEXANDER W. MACARA. CURE OF TOBACCO ADDICTION
SIR,-In recent issues of your journal there are discussions about smoking in children and adults. Perhaps it would interest your readers to know that in Stockholm, at the University Medical Clinic at the Karolinska Hospital, we have done some research into how to stop smoking. Our experience now includes about 4000 smokers, who all wished to stop smoking but who were unable to manage it themselves. Using a combination of knowledge, psychotherapy, and medical treatment we have had good results in 99% last year. 88% stopped entirely and another 11 % decreased their cigarette consumption to a quarter or less of what it was. Last year’s results were published at the annual meeting of the Swedish Medical Association on Dec. 3. Earlier publications appeared in the Svenska Läkartidningen 2and in the British Columbia Af7’r/7/ ’1m.lrnnZ.4
Department of Medicine, Karolinska Hospital, Stockholm.
BÖRJE EJRUP.
REFRIGERATED VENTILATION FOR OPERATING-THEATRES
SIR,-I write in support of Mr. Murley’s letter of Dec. 17. Since 1947 I have operated on about 5000 patients in temperatures ranging between 47°F and 60’F and can make nothing but favourable comments on the application of cooling in operating-theatres. I claim that, as a result, these patients have lost less blood and had fewer wound and chest complications and required lesser amounts of anaesthetic agents. " Surgical shock " has been almost eliminated, and transfusions of blood and/or saline have been seldom required. Furthermore, the surgeon has been able to complete his lists in greater comfort, and at the end he and the nursing staff (who after all are working in these excessively hot and humid atmospheres all day) were very much less tired. I hope later to publish my results of this series, but early mention of it has been forced upon me by the Ministry’s reluctance to install refrigerated ventilation in our new theatre suite which is shortly to be built. The surgical staff here, like Mr. Murley at St. Albans, have warned the regional board that refrigerated ventilation should be installed. It seems a pity that the Ministry of Health bulletin on operating-theatre suites should have been published on advice given by people who are obviously out of touch with modern operating requirements, and that such eminent men as Williams, Blowers, Garrod, and Shooter should have followed the same course without seeking the advice of those of us who are familiar with the advantages of refrigerated ventilation. Is it not time that surgeons should have a say under what conditions patients should be operated upon, and avoid leaving the decision to uninterested bodies who have not had the experience of the disasters of an overheated humid theatre 1. Tubercle, 1960, 41, 301. 2. Ejrup, B. Svenska Läkartidn. 1956, 3. Ejrup, B. ibid. 1959, 56, 1899. 4. Brit. Columb. med. J. July, 1960.
53, 2634.
further procrastination. X-ray Department, Royal Isle of Wight County Hospital, Ryde.
W. R. R. THURSFIELD.
GONADAL DYSGENESIS (TURNER’S SYNDROME) WITH MALE PHENOTYPE AND XO CHROMOSOMAL CONSTITUTION
SiRj—The case of this condition reported by Dr. Bloise colleagues1 is sufficiently unlike other cases of XO karyotype to raise the question of whether the reduction to 45 chromosomes has resulted from reciprocal translocation between X and Y,with loss of a small centric fragment of Y. Such a translocation could well yield a chromosome that would fit into the 6-12 group and would be expected to yield genitalia of the type displayed by the patient. and his
Department of Anatomy, The Medical School, Newcastle upon Tyne.
JOHN GRAY.
SMOKING AND SCHOOLCHILDREN
SIR,-In his report on the attitude of schoolchildren to smoking, quoted in your columns on Dec. 3 (p. 1240), the health education officer of Middlesex recommends wider publicity and enforcement of the law prohibiting under-16s from purchasing cigarettes. Let us face facts. This law has already been rendered impotent by the triumphal advent of the cigarette-vending machine, which literally any child can use. It is clear that the automatic vendor is here to stay, and enforces a frank and full reappraisal of our preventive policies. Legislation is no answer. Current law is an ass, and to propose fresh legislation (e.g., to illegalise smoking itself under a certain arbitrary age) is to court certain ridicule and make forbidden fruit sweeter still. Are we, then, to leave our children unprotected and uninformed, at a time when we are armed with a mounting mass of evidence of the hazards to health of cigarette-smoking ? Never was a rising generation exposed to grosser temptations. The wares are seductively advertised on all sides; pocket-money is invariably lavish, and the traditional forces of discipline and restraint are being steadily eroded by our pleasure-seeking
society. The
gravity of the problem among schoolchildren is well recognised, yet action has been negligible. If the remedy is to 1.
Bloise, W., de Assis, L. M., Bottura, C., Ferrari, I. Lancet, 1960, ii, 1059.
be found, it is in Mr. Penn’s own field. Only a concerted and urgent effort by all concerned, to decide upon and exploit the best means of propaganda, can hope to reduce the incidence of early addiction. As the report1 of the Joint Tuberculosis Council of Great Britain concludes, " Special efforts should be made to discourage young people from taking up smoking".
Perhaps the Central and Scottish Health Services Council Joint Committee on Health Education will address itself to this problem. We need an active policy, virile publicity, and-above all-a dynamic personal effort from all the members of our profession who have so shamefully neglected their duty to put the facts before the public. ALEXANDER W. MACARA. CURE OF TOBACCO ADDICTION
SIR,-In recent issues of your journal there are discussions about smoking in children and adults. Perhaps it would interest your readers to know that in Stockholm, at the University Medical Clinic at the Karolinska Hospital, we have done some research into how to stop smoking. Our experience now includes about 4000 smokers, who all wished to stop smoking but who were unable to manage it themselves. Using a combination of knowledge, psychotherapy, and medical treatment we have had good results in 99% last year. 88% stopped entirely and another 11 % decreased their cigarette consumption to a quarter or less of what it was. Last year’s results were published at the annual meeting of the Swedish Medical Association on Dec. 3. Earlier publications appeared in the Svenska Läkartidningen 2and in the British Columbia Af7’r/7/ ’1m.lrnnZ.4
Department of Medicine, Karolinska Hospital, Stockholm.
BÖRJE EJRUP.
REFRIGERATED VENTILATION FOR OPERATING-THEATRES
SIR,-I write in support of Mr. Murley’s letter of Dec. 17. Since 1947 I have operated on about 5000 patients in temperatures ranging between 47°F and 60’F and can make nothing but favourable comments on the application of cooling in operating-theatres. I claim that, as a result, these patients have lost less blood and had fewer wound and chest complications and required lesser amounts of anaesthetic agents. " Surgical shock " has been almost eliminated, and transfusions of blood and/or saline have been seldom required. Furthermore, the surgeon has been able to complete his lists in greater comfort, and at the end he and the nursing staff (who after all are working in these excessively hot and humid atmospheres all day) were very much less tired. I hope later to publish my results of this series, but early mention of it has been forced upon me by the Ministry’s reluctance to install refrigerated ventilation in our new theatre suite which is shortly to be built. The surgical staff here, like Mr. Murley at St. Albans, have warned the regional board that refrigerated ventilation should be installed. It seems a pity that the Ministry of Health bulletin on operating-theatre suites should have been published on advice given by people who are obviously out of touch with modern operating requirements, and that such eminent men as Williams, Blowers, Garrod, and Shooter should have followed the same course without seeking the advice of those of us who are familiar with the advantages of refrigerated ventilation. Is it not time that surgeons should have a say under what conditions patients should be operated upon, and avoid leaving the decision to uninterested bodies who have not had the experience of the disasters of an overheated humid theatre 1. Tubercle, 1960, 41, 301. 2. Ejrup, B. Svenska Läkartidn. 1956, 3. Ejrup, B. ibid. 1959, 56, 1899. 4. Brit. Columb. med. J. July, 1960.
53, 2634.