The rapid transit system for patients with fractures of proximal femur

The rapid transit system for patients with fractures of the proximal femur consists of immediate internal fixation or replacement of the fractured bone under spinal anaesthesia, without any sedation. Patients are mobilised within hours of surgery and sent home as soon as they can walk. They are supervised at home by both an experienced physiotherapist and a visiting nurse. Sixty nine patients admitted to a metropolitan teaching hospital were considered for the system and 50 were accepted. Their age distribution and level of general ill health were comparable with those in other series. The rapid transit system resulted in 90% of patients accepted being discharged to their homes within the first five days, with a lower morbidity and a mortality at three months of 7%. Using the rapid transit system rehabilitation in the original environment is difficult only if the patient lives alone, and even then temporary support is often enough to allow them to return home.     

Feto-maternal surveillance in labour: a new approach with an on-line microcomputer

Summary. A new method of real-time computer surveillance during labour is described with a commercially available'low-cost' microcomputer and integral video display unit (VDU). The fetal monitoring program gives accurate and reliable information on eight parameters of fetal and maternal wellbeing, four of which may be displayed simultaneously, with the facility of instant data recall. Emphasis is on simplicity of operation, and clarity of data display in the form of horizontal bar graphs updated at 5-min intervals, with most recent information in numerical form. Flexibility of the system enables program modification with relative ease, and adaptation to two unmodified commercial electronic fetal monitors.     

Topical 5-fluorouracil in the treatment of vaginal intraepithelial neoplasia

Summary. The effectiveness of 5-fluorouracil (Efudix) in the treatment of vaginal intraepithelial neoplasia was assessed in 14 patients diagnosed with the condition between January 1980 and December 1982. All patients received a standard dose of 2.5 g 5-fluorouracil cream once weekly f o r at least 10 consecutive weeks: mean duration of treatment was 12 weeks (range 10–20 weeks). The vaginal lesion was associated with a major dysplastic lesion of the cervix in all patients. The duration of follow-up ranged from 4 t o 42 months (mean 15 months). Thirteen patients had complete resolution both colposcopically and cytologically. One patient still had colposcopic evidence of intraepithelial neoplasia (aceto-white epithelium) but a vaginal smear has been negative. This patient has since been lost t o follow-up. We conclude that in t h e regimen described 5-fluorouracil is an effective treatment f o r vaginal intra-epithelial neoplasia.