Cervical screening in an inner city area: response to a call system in general practice.

To determine whether a cervical screening call system based in general practice in a deprived inner city area would increase the numbers of women who came forward for cervical smears the response to letters of invitation for screening was monitored for one year in one general practice in the Paddington and North Kensington district of London. Women aged 20-64 were identified from the computerised age-sex register. Only 16% of these women had had a smear test. A total of 750 call letters was sent out. Initially the response was poor (57 women; 22%), and 85 (32%) letters were returned marked "address unknown." After the age-sex register was updated the response to call was 330 women (44%). The response of women aged over 35 was better than the response of women aged 35 and under (229 (53%) v 101 (32%)). In the year of the study the number of women aged 20-64 on the revised register who had been screened rose by 330 (14%). A general practice based call system can improve uptake of cervical screening even in a highly mobile, socially underprivileged population.

When should a urine specimen be examined after removal of a urinary catheter?

Catheter urine specimens (CSUs) were taken from 72 patients with short term urinary catheters just before the catheter was removed. The patients were assessed to see whether this specimen influenced their management. Their subsequent urinary symptoms were followed, and daily mid stream urines (MSUs) compared with the initial CSU to see if the initial CSU gave an accurate indication of the likelihood of infection when the catheter was removed. Only one patient was given antimicrobial therapy as a consequence of the initial CSU, and 18 patients (25 per cent) showed significant growth on the CSU but no growth or a non-significant growth on subsequent MSUs. It would appear that CSUs taken prior to the removal of urinary catheters are of limited value.