A Self-Contained Method of Evaluating the Provision of Preventive Care in General Practice

In an earlier paper a method was described by which generalpractitioners are able to obtain dissatisfaction data from theirpatients by means of questionnaires. A similar approach hasbeen used to study preventive care activities of general practitioners.We have found it to be practicable and acceptable to patientsand surgery personnel. It also yields results which are consistentand which have apparently stimulated some practitioners to altertheir practice behaviour by increasing their preventive careactivities.     

Guidelines for the management of chronic venous leg ulceration. Report of a multidisciplinary workshop

This document is the product of a multidisciplinary workshop held in November 1991 between the audit subcommittee of the British Association of Dermatologists and the Research Unit of the Royal College of Physicians. Partieipants included dermatologists, vascular surgeons, general practitioners, community nurses and physicians involved in care of the elderly. The text is based on papers submitted to, and presented and discussed at, the workshop, and on comments received in response to subsequent wide dissemination of the proceedings to speciality associations. Participants in the workshop, and contributors to the guidelines are: Dr B.R.Allen (Nottingham), Sister S.Bainsborough (Exeter), Professor K.Burnand (London), Professor D.Burrows (Belfast), Mr M.J.Caflam (Bedford), Dr G.W.Cherry (Oxford), Dr R.P.R.Dawber (Oxford). Dr W.S.Douglas (Airdrie), Dr A.Y.Finlay (Cardiff), Dr D.Gawkrodger (Sheffield), Dr D.J.Gould (Truro), Dr A.Hopkins (Royal College of Physicians, London), Dr D.McGibbon (London), Dr A.M.Middleton (London), Dr L.Millard (Nottingham), Dr L.Rhodes (Liverpool), Professor T.J.Ryan (Oxford), Dr N.B.Simpson (Newcastle), Dr F.D.Skerrett (Fowey). Dr J.M.Sowden (Nottingham), Miss L.A.Stone (London), Dr R.Williams (Rhyl). Papers presented to the workshop (copies available from the Royal College of Physicians of London):     

COMPARISON OF I.M. KETOROLAC TROMETAMOL AND MORPHINE SULPHATE FOR PAIN RELIEF AFTER CHOLECYSTECTOMY

I.m. ketorolac trometamol 30 mg was compared with morphine sulphate10 mg after chole-cystectomy in a double-blind, multiple dose,randomized study of 100 patients. Assessments of pain were madeimmediately after operation (day 1), and the next morning (day2). Pain intensity (verbal response score and visual analoguescale) was recorded before injection and then over a 6-h period.Pain relief was assessed also. The effect of ketorolac on operativeblood loss and platelet function was examined. Time to commencingoral intake and the duration of administration of i.v. fluidswere recorded. Adverse events were noted. Ketorolac producedsignificantly less analgesia than morphine on day 1, but onday 2 the two drugs produced a similar effect. Blood loss wasnot increased by ketorolac, although platelet function was impaired.Repeated i.m. administration of ketorolac did not produce anyserious adverse effects.