serum calcium level, parathyroid activity and bone resorption (though apparently not on trabecular bone loss) in normal adults. 1,2 In the often cited study by Matkowic, Kostial and Siosonovich3 a cohort of Yugoslavian women with a high calcium intake (about 900 mg/d) was found to have a greater bone mass at maturity (a critical factor in susceptibility to osteoporosis in later life) than a cohort with half this intake. However, there were also ethnic, genetic and occupational differences between the two groups: the high-calcium-intake group consisted of goatherders and the low-calcium-intake group women from urban areas. It is noteworthy that there was no difference between the two groups in postmenopausal bone loss. With respect to Dr. Fromberg's letter, as a member of both the Scientific Review Committee for the 1990 Nutrition Recommendations4 and of the "senior population" I can attest that the recommendations were not formulated by the government or with any deference to the meat and dairy industries. Although there is evidence5 that postmenopausal women should comply with the recommended intake of 800 mg/d higher intakes appear to confer no additional benefit. Early claims that vegetarians have less bone loss than nonvegetarians have not been confirmed. Harold H. Draper, PhD Professor emeritus Department of Nutritional Sciences University of Guelph Guelph, Ont.
References 1. Calvo MS, Kumar R, Heath H: Elevated secretion and action of serum parathyroid hormone in young adults consuming high phosphorus, low calcium diets assembled from common foods. J Clin Endocrinol Metab 1988; 66: 823829 2. Yuen DE, Draper HH, Trilok G: Effect of dietary protein on calcium metaboSEPTEMBER 1, 1991
lism in man. Nutr Abstr Rev 1984; 54: 447-459 3. Matkowic V, Kostial K, Siosonovich I et al: Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 1979; 32: 540-549 4. Nutrition Recommendations: the Report of the Scientific Review Committee, Dept of National Health and Welfare, Ottawa, 1990: 199 5. Draper HH, Piche LA, Gibson RS: Effects of a high protein intake from common foods on calcium metabolism in a cohort of postmenopausal women. NutrRes 1991; 11: 273-281
Prenatal diagnosis: the medical genetics perspective D
~r. Malcolm N. Beck regards "eugenic abortion" as unacceptable (Can Med Assoc J 1990; 143: 181-186). The Ethics and Public Policy Committee of the Canadian College of Medical Geneticists accepts "termination of an affected pregnancy" as an option until such time as prevention or cure of genetic disorders renders it redundant (Can Med Assoc J 1991; 144: 1129-1132). The dilemma faced by the pregnant woman involved in prenatal diagnosis - at least those with whom I have spoken - has to do with whether destroying fetal life is right or wrong. She faces not a reproductive decision (she feels she has already reproduced) but, rather, a gripping moral decision related to her perceptions of life and of a potential life with a disabled offspring. To various degrees the human characteristic that (usually) keeps us from killing others is operative in her deliberations. If fortunate she receives empathic support in resolving her dilemma from her partner, family and professional advisers. In anticipating a time when further research has yielded prevention or cure the Ethics and Public Policy Committee has
failed to recognize that the ethical dilemma will likely continue. The options available to women then, presumably, will be termination (a traditional option), prenatal treatment of the fetus (with its attendant risks and benefits) and no treatment (when the perceived risks outweigh the benefits or termination is unacceptable to the woman involved). Bruce D. McCreary, MD Associate professor Department of Psychiatry Queen's University Kingston, Ont.
Acute allergic interstitial pneumonitis induced by hydrochlorothiazide
[correction]
I n the French translation of the abstract of this article (Can Med Assoc J 1991; 145: 2834), by Drs. Pierre Biron, Jacques Dessureault and Edward Napke, pneumonie was used instead of pneumonite. We apologize to the authors and the readers for any inconvenience this error may have caused. - Ed.
Lecture Notes on Occupational Medicine
Icorrection] I
Dr. John L. Weeks's review (Can Med Assoc J 1991; 145: 136-137) of H.A. Waldron's book the opening sentence should n
have read, with the corrected portion in italics: "If, when teaching occupational medicine to medical students, one can leave the students with the habit of asking patients the often neglected question 'What is your work?' a great deal will have been achieved." We apologize for any confusion our editing may have caused. -Ed. CAN MED ASSOC J 1991; 145 (5)
391
References 1. Calvo MS, Kumar R, Heath H: Elevated secretion and action of serum parathyroid hormone in young adults consuming high phosphorus, low calcium diets assembled from common foods. J Clin Endocrinol Metab 1988; 66: 823829 2. Yuen DE, Draper HH, Trilok G: Effect of dietary protein on calcium metaboSEPTEMBER 1, 1991
lism in man. Nutr Abstr Rev 1984; 54: 447-459 3. Matkowic V, Kostial K, Siosonovich I et al: Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 1979; 32: 540-549 4. Nutrition Recommendations: the Report of the Scientific Review Committee, Dept of National Health and Welfare, Ottawa, 1990: 199 5. Draper HH, Piche LA, Gibson RS: Effects of a high protein intake from common foods on calcium metabolism in a cohort of postmenopausal women. NutrRes 1991; 11: 273-281
Prenatal diagnosis: the medical genetics perspective D
~r. Malcolm N. Beck regards "eugenic abortion" as unacceptable (Can Med Assoc J 1990; 143: 181-186). The Ethics and Public Policy Committee of the Canadian College of Medical Geneticists accepts "termination of an affected pregnancy" as an option until such time as prevention or cure of genetic disorders renders it redundant (Can Med Assoc J 1991; 144: 1129-1132). The dilemma faced by the pregnant woman involved in prenatal diagnosis - at least those with whom I have spoken - has to do with whether destroying fetal life is right or wrong. She faces not a reproductive decision (she feels she has already reproduced) but, rather, a gripping moral decision related to her perceptions of life and of a potential life with a disabled offspring. To various degrees the human characteristic that (usually) keeps us from killing others is operative in her deliberations. If fortunate she receives empathic support in resolving her dilemma from her partner, family and professional advisers. In anticipating a time when further research has yielded prevention or cure the Ethics and Public Policy Committee has
failed to recognize that the ethical dilemma will likely continue. The options available to women then, presumably, will be termination (a traditional option), prenatal treatment of the fetus (with its attendant risks and benefits) and no treatment (when the perceived risks outweigh the benefits or termination is unacceptable to the woman involved). Bruce D. McCreary, MD Associate professor Department of Psychiatry Queen's University Kingston, Ont.
Acute allergic interstitial pneumonitis induced by hydrochlorothiazide
[correction]
I n the French translation of the abstract of this article (Can Med Assoc J 1991; 145: 2834), by Drs. Pierre Biron, Jacques Dessureault and Edward Napke, pneumonie was used instead of pneumonite. We apologize to the authors and the readers for any inconvenience this error may have caused. - Ed.
Lecture Notes on Occupational Medicine
Icorrection] I
Dr. John L. Weeks's review (Can Med Assoc J 1991; 145: 136-137) of H.A. Waldron's book the opening sentence should n
have read, with the corrected portion in italics: "If, when teaching occupational medicine to medical students, one can leave the students with the habit of asking patients the often neglected question 'What is your work?' a great deal will have been achieved." We apologize for any confusion our editing may have caused. -Ed. CAN MED ASSOC J 1991; 145 (5)
391
