Assessment of the professional behaviour of doctors is increasingly recognized as an essential component of doctors' training (Ben-David et al., 2004) with equally important implications for doctors in permanent posts. TAB is a proforma for such assessment using a 360 degree process in which up to 15 colleagues of a doctor assess that doctor's professional behaviour. The pro forma is presented, together with discussion of the format and approach developed, with particular reference to the General Medical Council document "Good Medical Practice". We report on initial piloting of the approach in two UK NHS hospital trusts. In total 440 assessments of 30 doctors were completed. Data regarding intra-observer and inter-observer variation indicate that the process is reliable, practical and consistent. We believe this approach may represent a workable way ahead to promoting appropriate professional behaviour on the part of medical trainees and that it offers potential for re-validation of hospital consultants. There is a clear need for further development and evaluation of this approach, most notably its acceptability and value to all involved.

Abstract. Treatment with the fibrinolytic inhibitor tranexamic acid was investigated in 12 women with vaginal bleeding in the second half of pregnancy. The aim of the therapy was to accelerate haemostasis in the uteroplacental circulation and to prevent further bleeding at the placental site. Tranexamic acid 1 g 8-hourly was given for 7 days. Serial investigations of coagulation and fibrinolysis were carried out. Plasma fibrinolytic activity, plasminogen, antiplasmin and platelet count significantly decreased during treatment, while antithrombin III and factor VIII related antigen showed a significant increase. Plasma tranexamic acid levels ranged from 5 mg/l to 17 mg/l. Two patients on treatment at the time of delivery had plasma tranexamic acid levels of 9 mg/l and 12 mg/l detected in the umbilical cord venous blood. No adverse effects were detected in any of the mothers and all 12 were delivered of live born infants. Tranexamic acid may have a therapeutic role in accelerating haemostasis in the uteroplacental circulation and thereby reducing the adverse effects of bleeding at the placental site.

Eighty-six patients with balanitis/balanoposthitis who presented at the department of genitourinary medicine in Coventry between October 1989 and August 1990 were investigated. While 34 (41%) cases had no specific aetiological factor Candida spp. accounted for 26 cases (30%), and group B beta haemolytic streptococci for 11 cases (13%) (one patient, a diabetic, was culture positive for both Candida spp. and group B beta haemolytic streptococci). The remaining 14 patients had other miscellaneous causes of balanitis/balanoposthitis.