There was moderate agreement between paramedic and ED or hospital diagnosis. The number of cases with no clearly documented working diagnosis suggested that a singular working diagnosis may not always serve the complexity of presentation of some dyspnoea patients: more open descriptors such as 'mixed disease' or 'atypical features' should be encouraged.

Uterine artery embolization (UAE) as a treatment option for fibroids was first reported by Ravina in 1995. Although rapidly adopted by enthusiasts, many were skeptical and its introduction varied widely across the globe. It was not until randomized controlled trials and registries were published and national guidance statements issued that UAE was accepted as a safe and proven treatment for fibroids. The technique is now established as one of the treatment options to be discussed with patients as an alternative to surgery for fibroid-associated heavy menstrual bleeding. Research is on-going to evaluate the relative merits of UAE compared with other medical and surgical treatment options for heavy menstrual bleeding, particularly for women wishing to maintain their fertility.

This article reviews the importance of preinterventional cross-sectional imaging in the evaluation of peripheral arterial disease, as well as discussing the pros and cons of each imaging modality. The importance of a multidisciplinary team approach is emphasized.

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BackgroundThe serum marker Procalcitonin (PCT) has been shown to be a sensitive indicator of bacterial infection, but very little is known of its behavior in periprosthetic infection. In this study, PCT was compared with standard tests used to aid the diagnosis of infection. As a baseline, its pattern in uncomplicated hip and knee arthroplasty was investigated.MethodsA prospective study of fifty-nine patients had bloods taken preoperatively, and on days 1, 3, 5, for PCT, C- reactive protein, erythrocyte sedimentation rate and white cell count.ResultsFifty patients (85%) had normal PCT values (< 0.5 ng/ml) and only 5 recorded a value > 1.0ng/ml. On day 5 only 1 patient had a value > 0.5ng/ml. The standard tests all showed sporadic elevations over the 3 days. PCT levels are not significantly elevated by the trauma of this surgery, as they are in other surgical procedures.ConclusionsPCT may be very useful in patients with suspected periprosthetic infection.KeywordsInfection; Periprosthetic; Procalcitonin; C-reactive protein; Arthroplasty