181
CVS samples per quarter was 34-5. During the quarter following the first article (April-June, 199 1) only 26 specimens were received which is the lowest quarterly figure for the three years. During the quarter after the second paper (July-Sept, 1991), only 30 samples were received; this is the fourth lowest quarterly figure for the three years. The slightly larger overall number of CVS samples for 1991 is explained by higher figures in the first and last quarters of the year. In 1991 there was no change in either the quarterly or annual numbers of amniocenteses compared with the previous two years. These two low quarterly figures for CVS in 1991 might reflect the effect of the two articles and the attendant publicity. We have no evidence that any effect persisted beyond the third quarter of the year. Department of Obstetrics and Gynaecology, Queen’s Medical Centre, Nottingham NG7 2UH, UK
D. JAMES
Southwestern Regional Southmead Hospital, Bristol
D. BICKLEY T. DAVIES A. MCDERMOTT
Cytogenetics Centre,
1. Firth HV, Boyd PA, Chamberlain P, MacKenzie
IZ, Lindenbaum RH, Huson SM. Severe limb abnormalities after chorion villus sampling at 56-66 days’ gestation. Lancet 1991; 337: 762-63. 2 MRC working party on the evaluation of chorionic villus sampling. Medical Research Council European trial of chorion villus sampling. Lancet 1991; 337: 1491-99.
The commercial pyramid SlR,-The eating right pyramid produced by the US Department of Agriculture1 has been widely publicised (with quotation of the source) in the advertisement of the largest multinational Italian pasta and baked goods producer, with a domestic market share of 34% for pasta and 28-5% for baked goods in 1990.2 This advertisement has frequently appeared over the past few months in the major Italian newspapers and magazines, and may well have been regarded by the general public as a sincere interest in the promotion of public health. At least two major changes, however, were introduced in this commercial version: pasta was given greater importance than in the US version, and no mention was made of sweets (figure). We can overlook the prominence that pasta acquired, since this is understandable on account of Italian dietary habits. Less justifiable is the elimination of any explicit message from the "use sparingly" (top)of the pyramid. No food picture is shown, and sweets are n
omitted from the Italian version. The Italian text now includes fats, oils, and sugar (instead of sweets) in this category. Thus, the same enterprise that finds it useful to publicise the recommendations of the US Department of Agriculture in respect of pasta is hesitant to threaten its vastly advertised production of
doubtful-origin, fat-rich biscuits and cakes. I believe that there are wide and serious implications of such deceptive use of a health warning originally produced by an independent source. Centro di Riferimento Oncoligico, 33081 Aviano, Pordenone, Italy 1. 2.
SILVIA FRANCESCHI
Department of Agriculture. The eating right pyramid. Science 1991; 252: 917. Company profile Barilla G. e R Fratelli SpA. Eurofood 1992 January: 18-19.
Employment of disabled people SIR,- There is an inherent contradiction in the title of your July 4 (p 44). It is much more sensible to employ able people than
note
disabled people. The fact that some able people have disabilities should not distract us. It is not a kindness to employ anyone in a job that he or she is not able to do. As a house officer with a disability, I am well aware of the widespread opinion that the employment of disabled people means the employment of people not properly competent--employed out of compassion, whose deficiencies will have to be compensated for by their able colleagues. The National Health Service is not, in my experience, much better or worse than other employers for whom I have worked. You say that "the disability issue was seen as an employment one and led by the personnel department". Unfortunately, the personnel department is usually the stronghold of the compassionate employment ethos. The consultants for whom I work were immediately aware that I have advantages as well as disadvantages. They seemed to perceive my presence on their firm as neither a particular bonus nor an unfortunate deficit; the net balance is probably neither positive nor negative. I am slower at some parts of the job, but better at others than my able colleagues. Overall, I think I do the job reasonably well. But when dealing with the personnel department, I find I often have to contend with the opinion that I am not quite a proper house officer, and have been employed for my own good rather than that of the hospital. Such strategies as ring-fencing vacancies can only help to reinforce the fallacy that disabled people ought to be employed. Instead, I should like to see a concerted effort to produce a low-handicap working environment, and a policy of employing able people. "Able" is not synonymous with "able-bodied". 11 Christchurch Avenue, London NW6 7QP, UK
SUSANNAH KAHTAN
Debrisoquine 4-hydroxylase (CYP2D) locus possible susceptibility to schizophrenia
and
The Barilla commercial version of the
eating right pyramid.
A, fats, oils, and sugar; B, food of animal origin, needed for daily provision of protein; C, food of vegetable origin, needed for daily provision of mineral salts, fibre, and vitamins, D, derivatives of cereals such as pasta, bread, and rice-these products, a source of carbohydrates, are at the base of the pyramid because they provide 60%
of daily calorie intake • = fats, oils. V=sugars. A’, the base of the pyramid appears "Fonte [source] United States u-aartment of Agriculture".
SIR,-Findings1,2 of an association between susceptibility to Parkinson’s disease and debrisoquine 4-hydroxylase (CYP2D6) gene mutations may also be relevant to schizophrenia. As in Parkinson’s disease, schizophrenia is influenced by genetic3 and environmental factors,4 and dopaminergic neurotransmitter systems are implicated in its pathophysiology.s Many of the drugs used to treat schizophrenia block dopamine receptors, and are metabolised in the liver and possibly in the brain by CYP2D6.6 In addition, the hallucinogen 4-methoxyamphetamine is, in part, metabolised by CYP2D6, and poor metabolisers may be more prone to the psychotoxic effects of these compounds.6 Furthermore, CYP2D6 may be involved in the catabolism and processing of neurotransmitters subsequent to reuptake into the neuron. Thus the enzyme may be related to the dopamine transporter, and abnormality of this protein may compromise neuronal response to transmitters .7 The locus for debrisoquine 4-hydroxylase can therefore be regarded as a candidate gene for schizophrenia. To test this hypothesis, we selected a highly polymorphic dinucleotide (CA) repeat marker (polymorphism information content =0-7) located 1.3 kilobases downstream from exon 9 of debrisoquine 4-hydroxylase gene at 22q138 and genotyped 188
CVS samples per quarter was 34-5. During the quarter following the first article (April-June, 199 1) only 26 specimens were received which is the lowest quarterly figure for the three years. During the quarter after the second paper (July-Sept, 1991), only 30 samples were received; this is the fourth lowest quarterly figure for the three years. The slightly larger overall number of CVS samples for 1991 is explained by higher figures in the first and last quarters of the year. In 1991 there was no change in either the quarterly or annual numbers of amniocenteses compared with the previous two years. These two low quarterly figures for CVS in 1991 might reflect the effect of the two articles and the attendant publicity. We have no evidence that any effect persisted beyond the third quarter of the year. Department of Obstetrics and Gynaecology, Queen’s Medical Centre, Nottingham NG7 2UH, UK
D. JAMES
Southwestern Regional Southmead Hospital, Bristol
D. BICKLEY T. DAVIES A. MCDERMOTT
Cytogenetics Centre,
1. Firth HV, Boyd PA, Chamberlain P, MacKenzie
IZ, Lindenbaum RH, Huson SM. Severe limb abnormalities after chorion villus sampling at 56-66 days’ gestation. Lancet 1991; 337: 762-63. 2 MRC working party on the evaluation of chorionic villus sampling. Medical Research Council European trial of chorion villus sampling. Lancet 1991; 337: 1491-99.
The commercial pyramid SlR,-The eating right pyramid produced by the US Department of Agriculture1 has been widely publicised (with quotation of the source) in the advertisement of the largest multinational Italian pasta and baked goods producer, with a domestic market share of 34% for pasta and 28-5% for baked goods in 1990.2 This advertisement has frequently appeared over the past few months in the major Italian newspapers and magazines, and may well have been regarded by the general public as a sincere interest in the promotion of public health. At least two major changes, however, were introduced in this commercial version: pasta was given greater importance than in the US version, and no mention was made of sweets (figure). We can overlook the prominence that pasta acquired, since this is understandable on account of Italian dietary habits. Less justifiable is the elimination of any explicit message from the "use sparingly" (top)of the pyramid. No food picture is shown, and sweets are n
omitted from the Italian version. The Italian text now includes fats, oils, and sugar (instead of sweets) in this category. Thus, the same enterprise that finds it useful to publicise the recommendations of the US Department of Agriculture in respect of pasta is hesitant to threaten its vastly advertised production of
doubtful-origin, fat-rich biscuits and cakes. I believe that there are wide and serious implications of such deceptive use of a health warning originally produced by an independent source. Centro di Riferimento Oncoligico, 33081 Aviano, Pordenone, Italy 1. 2.
SILVIA FRANCESCHI
Department of Agriculture. The eating right pyramid. Science 1991; 252: 917. Company profile Barilla G. e R Fratelli SpA. Eurofood 1992 January: 18-19.
Employment of disabled people SIR,- There is an inherent contradiction in the title of your July 4 (p 44). It is much more sensible to employ able people than
note
disabled people. The fact that some able people have disabilities should not distract us. It is not a kindness to employ anyone in a job that he or she is not able to do. As a house officer with a disability, I am well aware of the widespread opinion that the employment of disabled people means the employment of people not properly competent--employed out of compassion, whose deficiencies will have to be compensated for by their able colleagues. The National Health Service is not, in my experience, much better or worse than other employers for whom I have worked. You say that "the disability issue was seen as an employment one and led by the personnel department". Unfortunately, the personnel department is usually the stronghold of the compassionate employment ethos. The consultants for whom I work were immediately aware that I have advantages as well as disadvantages. They seemed to perceive my presence on their firm as neither a particular bonus nor an unfortunate deficit; the net balance is probably neither positive nor negative. I am slower at some parts of the job, but better at others than my able colleagues. Overall, I think I do the job reasonably well. But when dealing with the personnel department, I find I often have to contend with the opinion that I am not quite a proper house officer, and have been employed for my own good rather than that of the hospital. Such strategies as ring-fencing vacancies can only help to reinforce the fallacy that disabled people ought to be employed. Instead, I should like to see a concerted effort to produce a low-handicap working environment, and a policy of employing able people. "Able" is not synonymous with "able-bodied". 11 Christchurch Avenue, London NW6 7QP, UK
SUSANNAH KAHTAN
Debrisoquine 4-hydroxylase (CYP2D) locus possible susceptibility to schizophrenia
and
The Barilla commercial version of the
eating right pyramid.
A, fats, oils, and sugar; B, food of animal origin, needed for daily provision of protein; C, food of vegetable origin, needed for daily provision of mineral salts, fibre, and vitamins, D, derivatives of cereals such as pasta, bread, and rice-these products, a source of carbohydrates, are at the base of the pyramid because they provide 60%
of daily calorie intake • = fats, oils. V=sugars. A’, the base of the pyramid appears "Fonte [source] United States u-aartment of Agriculture".
SIR,-Findings1,2 of an association between susceptibility to Parkinson’s disease and debrisoquine 4-hydroxylase (CYP2D6) gene mutations may also be relevant to schizophrenia. As in Parkinson’s disease, schizophrenia is influenced by genetic3 and environmental factors,4 and dopaminergic neurotransmitter systems are implicated in its pathophysiology.s Many of the drugs used to treat schizophrenia block dopamine receptors, and are metabolised in the liver and possibly in the brain by CYP2D6.6 In addition, the hallucinogen 4-methoxyamphetamine is, in part, metabolised by CYP2D6, and poor metabolisers may be more prone to the psychotoxic effects of these compounds.6 Furthermore, CYP2D6 may be involved in the catabolism and processing of neurotransmitters subsequent to reuptake into the neuron. Thus the enzyme may be related to the dopamine transporter, and abnormality of this protein may compromise neuronal response to transmitters .7 The locus for debrisoquine 4-hydroxylase can therefore be regarded as a candidate gene for schizophrenia. To test this hypothesis, we selected a highly polymorphic dinucleotide (CA) repeat marker (polymorphism information content =0-7) located 1.3 kilobases downstream from exon 9 of debrisoquine 4-hydroxylase gene at 22q138 and genotyped 188
