Does caffeine reduce postoperative bowel paralysis after elective laparoscopic colectomy? (CaCo trial): study protocol for a randomized controlled trial.

Background: Postoperative bowel paralysis is common after abdominal operations, including colectomy. As a result, hospitalization may be prolonged, thereby leading to increased cost. A recent randomized controlled trial showed that the consumption of regular black coffee after colectomy is associated with a significantly faster resumption of intestinal motility.

Mannan-binding lectin polymorphisms and serum levels in patients with endometriosis.

Objective: To investigate a possible association between endometriosis and low levels of mannan-binding lectin (MBL).

Study Design: Case-control study of blood samples from 100 patients with endometriosis compared with results from a group of 350 blood donors.

Result: The frequency of MBL levels <100ng/ml was 14.

IPMN: surgical treatment.

Purpose: Cystic pancreatic tumors are being detected more frequently, and particularly, intraductal papillary mucinous neoplasia (IPMN) has recently attracted increased attention. The detection rate of IPMN has increased over the last decade; however, management of this neoplasm remains controversial.

Methods: Based on a review of the relevant literature and the international guidelines, we discuss the diagnostic evaluation of IPMN, its treatment, and prognosis.

[Surgical treatment of fistula-in-ano--a journey between Skylla and Charybdis].

This review discusses the pathogenesis, symptomatology, diagnostic work-up, and treatment options for fistula-in-ano, which is a common condition that affects ~ 20 in 100,000 per year with a predominance for young males. Fistula-in-ano normally presents as an acute anorectal abscess that subsequently becomes established as a chronic discharging fistula. The illness is characterized by chronic perianal discharge and intermittent pain.

[Limited effect of gonadotrophin-releasing hormone analogues for patients with endometriosis].

A Cochrane review concluded that gonadotrophin-releasing hormone analogues (GnRHas) are more effective at relieving endometriosis-associated pain than no treatment/placebo, while there was not found any difference in pain relief between GnRHas and danazol or between GnRHas and intrauterine levonorgestrel. A high frequency of hypoestrogenic side effects was found for GnRHas, since none of the studies included add-back therapy. This review confirmed that GnRHas can be used for endometriosis therapy, but first choice of medical treatment should be oral contraceptives or intrauterine levonorgestrel.

[Internal herniation during pregnancy following gastric bypass surgery].

In Denmark, the number of bariatric operations, including gastric bypass surgery, has increased dramatically in recent years. Internal herniation as a possible cause of acute abdominal pain, is a well-known complication after gastric bypass operation. We report two cases of internal herniation during pregnancy following gastric bypass operation.

Diagnosis and treatment of rectovaginal endometriosis: an overview.

Rectovaginal endometriosis can be a cause of severe pain, dyspareunia and intestinal problems. A thorough examination is needed and should include diagnostic imaging, such as transvaginal or transrectal ultrasound or magnetic resonance imaging. Medical therapies, such as oral contraceptives, progestins and levonorgestrel-releasing intrauterine devices, all seem to reduce pain and should always be considered.

[Transrectal removal of displaced intrauterine device].

In this case a patient presented with an intrauterine device (IUD) which was displaced into the sigmoid. The IUD was successfully removed through a proctoscope under laparoscopic guidance. Displacement of IUD into the sigmoid is a rare complication and should be treated proactively.

Association of interleukin--10 promoter polymorphism and endometriosis.

Problem: inflammatory processes are believed to play an important role in the pathogenesis of endometriosis. Interleukin-10 (IL-10) is an important immunoregulatory cytokine. The biological actions are mainly inhibitory including inactivation of macrophages and inhibition of pro-inflammatory cytokines.

Quantitative analysis of the Stratus optical coherence tomography fast macular thickness map reports.

The cross sectional optical coherence tomography images have an important role in evaluating retinal diseases. The reports generated by the Stratus fast macular thickness scan protocol are useful for both clinical and research purposes. The centerpoint thickness is an important outcome measure for many therapeutic trials related to macular disease.

[Bilateral tubal pregnancy].

Bilateral tubal pregnancies are extremely rare and they are usually found after assisted reproductive techniques have been applied. A rare case of bilateral tubal pregnancy after natural conception, occurring in a woman without any predisposing factors for ectopic pregnancy, is presented. The condition was diagnosed during laparoscopic surgery, and she was optimally treated with conservative tubal surgery.

Quality issues in interpretation of optical coherence tomograms in macular diseases.

Purpose: To analyze the scan characteristics associated with poor-quality Stratus optical coherence tomograms submitted to a reading center for multicenter clinical trials.

Methods: Data from evaluation of 6,741 fast macular thickness map reports from trials involving age-related macular degeneration (AMD), diabetic macular edema, and retinal vein occlusion were analyzed. Optical coherence tomograms with an erroneous centerpoint thickness needing manual remeasurement (MR) were categorized as being of poor quality.

Indications of anti-HY immunity in recurrent placental abruption.

Problem: Placental abruption is a potential life-threatening condition for both the fetus and the mother, being significantly more common in pregnancies with male fetuses. The pathogenesis of placental abruption remains unknown. However, some recent reports point toward a maternal immune response against the fetus as a possible mechanism.

Low serum level of mannan-binding lectin is a determinant for pregnancy outcome in women with recurrent spontaneous abortion.

Objective: The purpose of this study was to investigate the genetic background for the previously reported finding of an increased frequency of low levels of mannan-binding lectin in couples with unexplained recurrent spontaneous abortion and to evaluate the impact of low mannan-binding lectin levels on future pregnancy outcome.

Study Designs: Mannan-binding lectin levels were measured in 217 women with unexplained recurrent spontaneous abortion and 111 of their husbands and were compared with corresponding measurements in 104 couples with uncomplicated reproductive histories and 210 blood donors. An investigation of the genetic polymorphism, which is largely responsible for serum mannan- binding lectin levels, was done by polymerase chain reaction methods with DNA from a subset of the patients and control subjects.