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Notes and News

THE PHENYLKETONURIA REGISTER

IN a recent review, phenylketonuria (P.K.U.) emerged asjust about the only condition for which, on the strictestcriteria, population screening was thought justified.l,2A unique feature of p.K.u. screening in Britain is the way inwhich the programme has been monitored, via a registerkept at Alder Hey Children’s Hospital in Liverpool andsupported by the Medical Research Council and the Depart-ment of Health. The register goes back to 1964, and Haw-croft and Hudson have reviewed the latest figures.3 3 Interms of coverage and the incidence of late cases theP.K.U. programme is a success, and dietary treatment inclassical P.K.U. is effective. The management of atypicalP.K.U. is more of a problem, but this variant is not common(5% among cases detected below age four months in theyears 1964-72). However, the report will raise a few

questions. Coverage is estimated to be 95%. In a typicalyear the register will record 60-70 new cases, so the un-screened might be expected to yield a few late diagnoses-but in 1972 and 1971 there were none. Secondly, althoughthe Guthrie test on blood is the most common method,some centres use paper or thin-layer chromatography,fluorimetry, or urine chromatography, and the yield ofpositive cases does vary quite strikingly from 1 per 6600 forpaper chromatography on blood to 1 per 15,000 for theGuthrie method. Thirty-seven laboratories handle speci-mens, but more centralisation-even the establishment of

just one laboratory for the whole of the United Kingdom-would be feasible. Links between local midwives and healthvisitors and a local laboratory are an important factor inmaintaining health workers’ enthusiasm. On the otherhand, P.K.u. is a very rare disease, and economies of scaleought to be considered. Is screening any less successfulin Scotland with just one laboratory than in England withthirty-four ?

MORE FOR RADIOGRAPHERS

THE eight professions supplementary to medicine (ofwhich the largest are the radiographers and physiotherapists)have won from Lord Halsbury’s committee of inquiry apay rise of 38%/ adding E13 million to the N.H.S. salarybill in a full year. More than half this increase is alreadybeing paid as a result of an interim award granted in thewake of the 30% pay rise for nurses. The traditional paylink between the nursing and the paramedical professionshas been broken. A career in these professions can nowoffer salaries up to E5118 per annum. Some heads of the

largest departments get over E2000 a year more (70%);a beginner, however, gets an extra E6.40 a week. LordHalsbury, in his anxiety to encourage full-timers and makeradiography and like professions attractive as careers forwomen, seems to have lost sight of some realities. Hospitalsare often dependent on married women for sessions orpart-time work in radiography, physiotherapy, orthoptics,and so on; and many in their younger days will have hadexperience in senior and specialised posts. Yet Halsburysees the payment of enhanced rates to part-timers as " asource of irritation and as a positive disincentive to accept-ance of full-time employment in the National HealthService "; and he is even forced to talk of protecting thesalaries of those whose pay might actually fall in his

paragraph-99 proposals.

1. Holland, W. W. Lancet, 1974, ii, 1494.2. Raine, D. N. ibid. p. 996.3. Hawcroft, J., Hudson, F. P. Hlth Trends, 1974, 6, 72.4. Smith, I., Wolff, O. H. Lancet, 1974, ii, 540.5. Report of the Committee of Inquiry into the Pay and Related

Conditions of Service of the Professions Supplementary to

Medicine and Speech Therapists. H.M. Stationery Office. 80p.

A FRESH LOOK AT CARDIAC ARRHYTHMIAS

IN May we published four articles under this title byDr D. M. Krikler. A second impression of an expandedversion of this series is now obtainable (price 40p,$1,prepaid, post free) from The Lancet, 7 Adam Street,London WC2N 6AD. Will the very large number ofreaders who have requested reprints from Dr Krikler

kindly note that free reprints of the articles as publishedwill not be generally available ?

SCREENING FOR DISEASE

REPRINTS of this twelve-week series will be available inFebruary. The cost, for orders received by the end ofJanuary, will be El ($2.50) post free, and orders, accom-panied by payment, should be sent to the London office ofThe Lancet, 7 Adam Street, London WC2N 6AD.

University of ManchesterDr Leela A. Ganguli has been appointed senior lecturer

in bacteriology, Dr M. D. W. Lye senior lecturer in

geriatric medicine, Dr D. C. Anderson senior lecturer inmedicine, Mr A. D. G. Brown senior lecturer in obstetricsand gynaecology, and Dr E. P. Owens lecturer in psychiatry.

University of AberdeenDr T. A. Jeffers has been appointed lecturer in thera-

peutics and clinical pharmacology.

Royal College of PathologistsA Kettle memorial lecture on applications of cell biology

to pathology will be given by Dr A. C. Allison at 5.30 P.M.on Tuesday, Feb. 4, at the Scientific Societies LectureTheatre, 23 Savile Row, London Wl.

Royal Society of ArtsA Sir Thomas Holland memorial lecture will be given by

Dr G. M. Bull for the Commonwealth section of the RoyalSociety of Arts at 5.15 P.M. on Tuesday, Feb. 4. The titleis Medical Research in the Commonwealth, with ParticularReference to Bilharzia. Applications for tickets should besent to the Secretary of the Society at John Adam Street,London WC2N 6EZ.

W.H.O. Centre for Anticoagulant Control ReagentsThe National Reference Laboratory for Anticoagulant

Control Reagents has been officially designated the WorldHealth Organisation collaborating centre for referenceand research into anticoagulant control reagents. Inquiriesshould be addressed to the director, Dr L. Poller, Withing-ton Hospital, University Hospital of South Manchester,Manchester M20 8LR.

Cholera in Saudi Arabia

The World Health Organisation has informed theDepartment of Health of an outbreak of cholera amongpilgrims to Mecca, and a further report mentions importa-tions of the disease to Kuwait. Those travelling to SaudiArabia are advised to be vaccinated against cholera.

Prof. W. S. Peart, F.R.S., has been appointed a trustee of theWellcome Trust in succession to Prof. Henry Barcroft, F.R.S.

CORRIGENDUM : Outbreak of Psychosomatic Illness at a RuralElementary School.-In the paper by Dr Richard J. Levineand his colleagues (Dec. 21, 1974, p. 1500) line 5 of the sectionon the background to the incident should read : "the staffnumber 27 (22 of them women)... "