Tandearil® Brief Prescribing Information Dosage In arthritis, extra-articular rheumatism and superficial thrombophlebitis - 400-600 mg per day (4-6 tablets). When improvement is obtained (generally in 2 or 3 days), the dose should be reduced to the lowest effective level. In severe trauma and its sequelae - 400600 mg (4-6 tablets) daily in divided doses for 4 days to a week. For indications in surgery - 400-600 mg (4-6 tablets) daily in divided doses during the 24 hours prior to surgery. As soon as oral medication can be resumed after surgery, maintenance is 300-400 mg daily for 3-4 days. It is suggested that the maintenance level not exceed 400 mg per day. Tandearil should be taken with meals or with a glass of milk. In the absence of a favourable response after a one week trial period, it is recommended that administration of Tandearil be discontinued. Contraindications Tandearil is contraindicated in patients with a history of blood dyscrasia or drug allergy and in those with a history or symptoms of peptic ulcer. In addition, it should not be given to senile patients, to patients with clinical edema or to those with severe renal, hepatic or cardiac disease. Precautions A careful history, physician examination and complete blood count should be done before initiating therapy. Patients receiving this drug should be followed closely and should be warned to discontinue Tandearil and contact their physician immediately should any of the following signs or symptoms appear: fever, sore throat, lesions in the mouth, black or tarry stools, skin reactions or a sudden gain in weight. Patients undergoing long-term therapy should have blood counts done at monthly intervals. Care should be taken when prescribing for the elderly. As with any drug, Tandearil should not be used during the first trimester of pregnancy unless in the opinion of the prescribing physician, the potential benefits outweigh the possible risks. Tandearil may prolong the effect of other drugs taken concomitantly. Special attention should be paid to this fact when anticoagulants are prescribed. Side Effects Nausea, vomiting, abdominal discomfort, formation or activation of peptic ulcer and sodium retention with edema are known to occur. Although rarely observed, hypersensitivity reactions, dermatological reactions and blood dyscrasias have been reported. Availability Tandearil Tablets Each light brown, sugar-coated tablet, branded . in brown, contains 100 mg oxyphenbutazone Geigy Standard. Supplied in bottles of 50 and 500. Full information is available on request.

Geigy Dorval 780, Quebec

G-4063

our statistical findings regarding the observed/expected ratios in Table II. The probabilities shown were based on x2 analyses in which sample sizes are taken into account. Of the six ratios in Table II marked as having a probable significance at the 1% level or less, Dr. Sellers states that very few would be significant even at the 5% level according to his criteria. Perhaps both Dr. Sellers and ourselves have committed the same sin of omission (which we have now corrected with this statement) by failing to specify the statistical test used. We recognize that in any application of statistics one is free to increase or decrease the probability level one personally accepts as convincing. We are impressed by the number of Eskimos with malignant tumours of the lung (particularly women), nasopharynx, salivary gland and uterine cervix, and the relative infrequency of breast cancer. This is why we have published our findings. We are pleased that Dr. Sellers and others have found our paper worthy of comment. 0. SCHAEFER, MD

Northern Medical Research Unit Charles Camsell Hospital Edmonton, Alta.

JA. HILDES, MD

Northern Medical Unit University of Manitoba Winnipeg, Man.

A Canadian institute of child health? To the editor: Over the next few months I shall be engaged in a study of the need for some such organization as an institute of child health to draw attention to the health needs of children. I shall be consulting with parents. physicians, nurses, social workers and other allied health workers, politicians, economists, administrators and members of existing organizations. Many of the problems in child health have been documented. The results of a national nutrition survey caused grave concern about the status of nutrition among Canadian children and teenagers. The Celdic report warned of a crisis situation in learning disabilities. Recent reports indicate an increasing incidence of teenage suicides. Child abuse is now recognized as a national problem. Accidents are the major cause of death between the ages of 2 and 5 years. Venereal disease is reported as having reached epidemic proportions among adolescents. There are many other concerns. It has been suggested that an institute of child health could identify problems and assign priorities; undertake studies to document these problems and propose solutions; secure "action" by stimulating public awareness, the

political process and legislation; act as a resource and information centre; provide liaison and coordination between child-health-related associations and institutions; and develop a national plan for the future health care of children. I would appreciate hearing personally from any physicians who have views on this subject. (MRS.) SHIRLEY POST, RN, MHA

48 Powell Ave. Ottawa, Ont. KIS 2A1

Physical fitness To the editor: In his letter commenting on physical fitness (Can Med Assoc J 113: 92, 1975) Dr. Sheehan concludes "Only when adults become playful will fitness follow and then only because it is not intended." I do not think of fitness as a byproduct of "play" but rather of "exertion", and few will have the energy to exert themselves to the point of perspiration, breathlessness, fatigue and pain from stressed tissues if they are chronically deficient in vitamins and minerals. Nutrition Canada has shown that the dietary intake of vitamin A and of calcium and iron is deficient in 48, 62 and 78%, respectively, of females in the age group 10 to 20 years. I believe that such individuals do not have the will to exert themselves. I believe that one of the basic requirements in the motivation to exert oneself is good nutrition. To ignore this premise is like whipping a starved horse. The best it can do is stand and gaze. CARL J. REICH, MD

205A Medical Centre Calgary, Alta.

"Le Rave Impossible" To the editor: I believe that some of the readers of the Journal will be interested in knowing that my Canadian historical novel "The Three Gifts" is now available in a French edition entitled "Le Rave Impossible". This edition has recently been recommended by the Library Association of Paris for inclusion in 10 of the libraries of that city. It is distributed by Libraire Dussault, 8955 boul. St-Laurent, Montreal, Qua. H2N 1M6. WILFRID PococK, MD

Huntsville, Ont.

Depression after myocardial infarction To the editor: In the paper "Depression after myocardial infarction" (Can Med Assoc J 113: 23, 1975) Kavanagh, Shephard and Tuck suggest that the presence or absence of depression is

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