The assessments by radiographers of 1628 consecutive patients referred for radiography in the casualty department were analysed. The radiographers missed abnormalities in the radiographs in 68 of the cases. Casualty officers missed abnormalities in 63 cases, but only 35 patients were common to both groups. Twenty eight of the radiographs interpreted wrongly by casualty officers were interpreted correctly by radiographers; 16 of these 28 were thought by the accident and emergency consultant to be clinically important.It is suggested that a system whereby radiographers signal abnormalities should be standard practice.

In a series of patients given hydroxychloroquine sulphate by mouth before and after major surgery the incidence of deep venous thrombosis in the legs, as assessed by iodine-125-tagged fibrinogen scanning and venography, was reduced to 5% compared with an incidence of 16% in a similar untreated group of patients.

was limited to one interview or occasionally two. Their prognosis tended to be worse than that of more intensively treated patients (Tables I and IV), and our results indicate that many of the patients who had only brief psychiatric contact subsequently benefited from further psychiatric treatment (Table II). The specific characteristics of patients who benefit mostand least-from psychiatric treatment will be described in a subsequent paper (Bagley and Greer, 1971).It was surprising to discover that more than one-fifth of the present series had no psychiatric contact whatsoever following their suicidal attempt. In most cases these patients were sent home because the casualty officer considered that there was no medical danger and the suicidal attempt was therefore a trivial matter. Our findings indicate that this assumption is both mistaken, since the degree of medical danger was not related to prognosis, and dangerous, since 39% of untreated patients made further suicidal attempts and 4.5% killed themselves within 18 months. These results lend force to the Central Health Services Council's (1968) recommendations: "All cases of deliberate self-poisoning should be referred to a designated poisoning centre, regardless of the seriousness or otherwise of their medical condition . . . they should never be sent home without undergoing psychiatric assessment."The present study shows that psychiatric treatment was associated with a significant fall in incidence of subsequent suicidal attempts. Since untreated patients are particularly liable to repeat suicidal attempts, and since multiple suicidal attempts increase the probability of eventual suicide (Ettlinger, 1964), it seems likely that adequate facilities for psychiatric treatment could save lives as well as reduce the repeat rate for parasuicide.We thank the patients whose co-operation made this study possible; Professor J. Anderson and Dr. D. Liddell for their encouragement; and Mr. I. Corkindale, who searched the General Register Office records for death entries.

No abstract

One hundred and six patients undergoing major surgery were given dextran 70‐500 ml. during operation, 500 ml. on the following day, and then 500 ml. on alternate days until discharge. Of these patients, I developed a deep venous thrombosis after the operation (0‐94 per cent). One hundred and one patients acted as control subjects and, of these, 10 developed deep venous thrombosis (9‐9 per cent). This reduction in incidence of thrombosis is significant at the 2 per cent level, indicating that dextran 70, as macrodex 6 per cent in 5 per cent dextrose, in the régime given is a simple and effective means of reducing deep venous thrombosis after major surgery.