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children and adolescents of the same county, showed a rateof sonographic changes eight times higher than in thecontrol group.The Byelorussians themselves are beginning to question
and to try to pinpoint why it has been so difficult to presenttheir case to the world. They observe that almost all the keyfigures in the nuclear establishment set up in the republicunder the communist regime were Russian incomers,appointed by Moscow. (The director of the Institute ofRadiation Medicine of the Byelorussian Ministry of Health,Dr Vladimir Matyukhin, for example, was formerly head ofradiation medicine with the Soviet Far Eastern Fleet).Immediately after the failed coup last August, the leadingByelorussian daily Zviazva began publishing summaries ofthe meetings of the Soviet Ministry of Health, which hadimposed a ban of secrecy on all matters relating to themedical consequences of the accident. Human rightscampaigners are now starting to call for the prosecution ofthe officials concerned, since the secrecy, by preventing anypreventive measures-such as iodine supplementation oreven a warning to stay indoors-was, they say, an offenceagainst the basic right to life and health. Such a prosecutionwould not be easy, since the decision-makers of that timewere in Moscow, now, technically, in a foreign country. Butin the months to come, the polictical "fallout" from
Chemobyl may prove to be no less significant than theradiation itself.
Irish abortion case
In 1983 the people of the Republic of Ireland voted by two to oneto amend Article 8 of the constitution, to include the words: "thestate acknowledges the right to life of an unborn child, with dueregard to the equal right of the life of the mother, guarantees in itslaws to request, and, as far as practicable, by its laws to defend andvindicate that right". In the High Court in Dublin Mr JusticeCostello has granted Ireland’s Attorney General an injunctionpreventing a 14-year-old rape victim from having her pregnancyterminated. She had left Ireland on Feb 6, but returned when theinterim injunction was granted; the girl had threatened suicide. Thejudge’s ruling was published on Feb 17. According to The
Independent (Feb 18), the Attorney General had directed that publicdiscussion of the case and the issues raised would be in contempt ofcourt. Officially 2000 women every year travel from the republic tothe UK for abortions (and the British Pregnancy Advisory Servicein London receives every week 25 such requests for help). The totalnumber is thought to be well over 2000, probably double. An appealto the Irish Supreme Court is possible but time is running out. Thecircumstances of the case are unusual in that it seems likely that anabortion outside Ireland could have been arranged smoothly.However, police advice was sought about forensic DNA testing onfetal material, and that set in motion the wheels of officialinterference.
Public discussion in Ireland has not, of course, been stifled. AnIrish Times editorial thunders about "a nightmare brought on by acombination of political cowardice and sectarian triumphalism,together with some genuinely but profoundly ill-informedidealism". All-party talks aimed at resolving the political crisis-butnot, perhaps, the girl’s personal one-are being set in motion. Afurther referendum (only 54% of the electorate voted last time) is apossibility.
Cells surviving a exposureIn radiation biology there are grays and grays: allowance has to be
made for the type of radiation. The ot particle, in terms of biologicaleffects dose for dose, is more potent than X radiation. This
complicates the interpretation of environmental radiation risks.Even so, it is still widely held that radiation from nuclear powerfacilities cannot explain leukaemia among children in the
neighbourhood. That view might need revision in the light offindings from the MRC Radiobiology Unit. A hit on the nucleuswill prove fatal to a cell; other cells may escape altogether-but whatof those merely wounded by an a particle? More dangerousapparently, for chromosome damage can appear in the progenyseveral divisions later. Wright and colleagues’ studied mousebone-marrow stem cells in culture and exposed them to radiationdoses from the a-emitter plutonium-238. The changes were notseen when X rays were used. According to Dr Eric Wright "We donot yet know whether the type of damage we have demonstratedreflects damage to stem cells that may lead to leukaemia", but it willbe in that context that bodies such as the UK Committee onMedical Aspects of Radiation and the Environment will no doubtwish to examine these findings.
1. Kadhim MA, Macdonald DA, Goodhead DT, Lorimore SA, Marsden SJ, WrightEG. Transmission of chromosomal instability after plutonium &agr;-particleirradiation. Nature 1992; 355: 738-40
A decade of AIDS research
Investigators of the acquired immunodeficiency syndrome(AIDS) may need to examine their research priorities. Ten yearsago, AIDS was a newly described condition about which little wasknown. However, in the past decade, research into the disease hasincreased dramatically. Elford and colleagues1 report a search of theMEDLINE database on CD-ROM (compact disc read-onlymemory) that shows that between 1981 and 1990 more than 30 000papers were indexed under the headings AIDS or HIV (humanimmunodeficiency virus). There was a 50-60% increase per yearbetween 1983 (646 papers) and 1988 (6801) in publications indexedunder these headings, but between 1988 and 1989 the rate of growthfell to 6%. The annual rate of growth of all papers on MEDLINEbetween 1981 (265 205) and 1990 (373 000) was about 3-6%.What were the main preoccupations of the AIDS papers indexed
on MEDLINE? Aetiology was the subject of 25% of all AIDSpublications in 1983 but only 3% in 1990; at the same time, paperson HIV increased from 2 to 37 % of the total. Prevention and controlwere the subjects of 6% of paper in 1984,18% in 1988, and 12% in1990. 1% of publications in 1983 were about drug therapycompared with 7% in 1990. The epidemiology of AIDS/HIV wasconsistently the concern of about 10% of papers throughout thedecade.
English was the language of the overwhelming majority (82 %) ofpapers on AIDS. Since many cases of AIDS occur in countrieswhere English is not the first language (the francophone countries ofAfrica for example), this finding raises questions about the
accessibility of published research in these countries. AIDS insub-Saharan Africa was discussed by only 3% of AIDS/HIVpapers indexed by MEDLINE between 1982 and 1990-over thesame period, a quarter of all AIDS cases were reported from Africa.Because of its origin in the USA, MEDLINE may be biasedtowards English-language publications, and the database does notindex all journals that deal with AIDS and HIV. However, a searchin The Lancet office of the AIDS CD-ROM database (MaxwellElectronic Publishing, Cambridge, Massachusetts, USA), whichcovers published research on AIDS additional to that indexed byMEDLINE, showed that only about 4% of papers discussedAIDS/HIV in sub-Saharan Africa. Thus, the limitations of theMEDLINE database are unlikely to account for the patterns ofAIDS/HIV research described by Elford and colleagues. There is aclear need to give priority in future AIDS research to thosecountries that will have to bear the greatest burden of this disease.
1. Elford J, Bor R, Summers P Research into HIV and AIDS between 1981 and 1990:the epidemic curve AIDS 1991; 5: 1515-19.