Finance, staffing and equipment constraints may offer significant impediments to troponin testing with a 1-h turnaround time.

The use of troponin T to facilitate early patient discharge was investigated in a prospective study in a district general hospital. Troponin T was measured in 91 patients admitted over a period of 6 months with chest pain but without evidence of myocardial infarction. The main outcome measure was length of hospital stay. A negative troponin T was found in 70 patients. Fifty of these were discharged within 24 h of the troponin result being available and they had a significantly shorter hospital stay than a case control group and a historical control group from the previous 6 months. Troponin T measurement has a role in altering patient management by enabling early discharge, resulting in significant cost savings and increasing bed availability.

No abstract

SUMMARYWe describe a patient presenting with voluminous diarrhoea, hypokalaemic acidosis and hypercalcaemia who was found to have a vasoactive intestinal polypeptide‐producing tumour. His diarrhoea was initially mild and intermittent requiring no medical attention.