Background Studies examining the use of C-reactive protein (CRP) as a predictor of chorioamnionitis in preterm prelabour rupture of membranes (PPROM) report highly conflicting results. Despite this, CRP is commonly used for the early diagnosis of chorioamnionitis.Objective To determine the diagnostic accuracy of CRP in the detection of chorioamnionitis in women with PPROM.Design Systematic review.Search strategy Studies were identified from MEDLINE , EMBASE (1974EMBASE ( -2006, PubMed and the Cochrane Library (2005) and from reference lists from primary studies and reviews.Selection criteria Only studies of good methodological quality that evaluated the diagnostic performance of CRP in chorioamnionitis in women with PPROM were selected.Data collection and analysis Positive and negative likelihood ratios (LR) and diagnostic odds ratios (DOR) were calculated. An attempt was made at pooling data for meta-analysis, but this was considered inappropriate due to the significant unexplained heterogeneity between studies.

This study was conducted to assess the effects in trained cyclists of exhausting endurance cycle exercise (CE) on maximal isometric force production, surface electromyogram (EMG) and activation deficit (AD) of the knee extensors. Ten male subjects made four isometric maximal voluntary contractions (MVC) of the knee extensor muscles immediately prior (pre), 10 min after (post) and 6 h after completion of CE. The CE consisted of 30 min of exercise on a stationary cycle ergometer at an intensity corresponding to 80% of maximal oxygen uptake (VO(2max)) followed by four x 60-s periods at 120% of VO(2max). Two MVC were performed with recording of surface EMG from the knee extensors, whilst an additional two MVC were completed with percutaneous electrical muscle stimulation (EMS; 25 pulses at 100 Hz with the maximal tolerable current) superimposed over the maximal voluntary contraction force (MVF) but without EMG (to avoid interference). The MVF, integrated EMG (iEMG), and AD [calculated as the difference between MVF and the electrically stimulated force (ESF) during the EMS contractions] were statistically analysed. The MVF was significantly reduced (P < 0.05) post and 6-h post compared to pre-CE level. The iEMG was significantly reduced (P < 0.05) post and 6 h post CE. The ESF was also reduced, whilst AD was significantly increased (P < 0.05) post and 6-h post CE compared to the pre CE. These results suggest that the level of exercise stress administered in this study was sufficient to impair the central and peripheral mechanisms of force generation in knee extensors for a period of 6-h. Athletes engaged in concurrent training (strength and endurance) should consider this effect in exercise programming.

Objective To compare the use of outpatient and inpatient procedures in the investigation of abnormal Design A randomised controlled trial.Setting Two university teaching hospitals.Participants Four hundred women with abnormal uterine bleeding (postmenopausal bleeding, menorrhagia, intermenstrual bleeding, postcoital bleeding, or irregular periods) above the age of 35 years, between June 1993 and January 1995.1. Incidence of detection of abnormal pathology by vaginal ultrasound, outpatient hysteroscopy and endometrial biopsy compared with inpatient hysteroscopy and curettage; 2. Number of 'lesions' (e.g. fibroids, polyps, endometrial hyperplasia or malignancy) found by hysteroscopy that would have been missed by the combination of endometrial sampling and ultrasound; 3. Comparison of the quality of tissue obtained for histology by outpatient endometrial sampling and inpatient curettage; and 4. An evaluation of patient acceptability of outpatient and inpatient procedures.

Objective To compare the use of outpatient and inpatient procedures in the investigation of abnormal Design A randomised controlled trial.Setting Two university teaching hospitals.Participants Four hundred women with abnormal uterine bleeding (postmenopausal bleeding, menorrhagia, intermenstrual bleeding, postcoital bleeding, or irregular periods) above the age of 35 years, between June 1993 and January 1995.1. Incidence of detection of abnormal pathology by vaginal ultrasound, outpatient hysteroscopy and endometrial biopsy compared with inpatient hysteroscopy and curettage; 2. Number of 'lesions' (e.g. fibroids, polyps, endometrial hyperplasia or malignancy) found by hysteroscopy that would have been missed by the combination of endometrial sampling and ultrasound; 3. Comparison of the quality of tissue obtained for histology by outpatient endometrial sampling and inpatient curettage; and 4. An evaluation of patient acceptability of outpatient and inpatient procedures.

Patient-reported outcomes have shown that TOT is not inferior to TVT, but both produce lower success rates than studies using objective measures.

The fetal cerebellum can be visualized with ultrasound throughout the second trimester. We describe a technique for measuring the transverse and anteroposterior cerebellar diameters and the measurement of the cisterna magna in the same plane between 14 and 32 weeks gestation. Nomograms for these measurements against gestational age showed good correlation, and narrow confidence limits for the transverse cerebellar diameter. The transverse cerebellar diameter was also measured directly in 79 fetuses after midtrimester abortion and the measurements obtained were compared with the ultrasound TCD nomogram. Good correlation, was obtained between the post mortem measurements and the ultrasound TCD nomogram. Routine use of these measurements and nomograms should prove valuable in the diagnosis of congenital abnormality of the posterior fossa and may also be of use in assessing the effect of severe intrauterine growth retardation and other insults on cerebellar growth and development. The narrow confidence limits obtained with the TCD nomogram should enable it to be used with confidence in clinical practice.

Many surgeons found it difficult to maintain a prospective otology database. The rates of certain subjective symptoms such as dysgeusia are influenced by how vigorously the reviewers prompt the response from the patients. Dysgeusia after stapes surgery is common even if the chorda tympani nerve is preserved. Many patients whose chorda tympani nerve is divided may not complain of dysgeusia.

Studied the development of a theory of multivariate personality styles that are considered to correspond to the character of specific diagnostic types. Theoretical descriptions of the personality styles of the hysteric, compulsive, character disorder, manic, and depressive were operationalized by predicting specific combinations of personality dimensions measured by previously validated personality measures. A test battery composed of scales hypothesized to operationalize these characteristics was administered to samples of male and female college students (N = 95). A short scale, the Multivariate Presonality Inventory, was devised to measure these styles and was found to be reliable and to exhibit concurrent validity with the full test battery. A cluster analysis methodology isolated clusters of males and females who corresponded to the predicted profiles of the hypothesized personality styles. Strongest support was found for the female hysteric, the male and female compulsive, the female character disorder, and the male manic personality style.