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HEMOGLOBIN-S-thalassemia disease (microdrepanocytic disease) is the result of double heterozygosity for the genes of hemoglobin S and thalassemia. Its highest incidence would be expected where areas of high density of thalassemia and sicklemia are geographically proximal. Sicily and southern Italy are such places, and recently Silvestroni and Bianco * have reported 57 cases in 28 families from there. In this country only 22 cases have been reported,† most of them in patients of Sicilian, Italian, or Greek ancestry. Indeed, most of the cases of sickle-cell anemia reported in white persons, in retrospect, were probably examples of S-thalassemia, and Chernoff15 in his excellent review estimates that there are at least 14 of these in the literature. Since thalassemia minor is known to occur also in the Negro,16 and we have seen six such cases, S-thalassemia would be expected to be found in this race. There are five reports ‡ of

To the Editor.—The original article by Dr. Day et al on "Acceptance of Pediatric Nurse Practitioners" in your March 1970 (119:204-208) issue was just what I have been waiting for before speaking out.It is gratifying and reassuring to hear that others find the solution to the work load in pediatrics just as comfortable as I do. Being alone in pediatrics covering an entire county with over 50,000 population, I have found great relief from the services of a fully trained pediatric nurse. The acceptance of her by my private patients has been overwhelming. She can make the decision whether a child is ill enough to be seen within an hour or can wait for complete evaluation, whether diets need be changed, and the hundred different questions that are to be answered by a pediatrician but can be handled by a well trained person with the ability of