Acute kidney injury after gynaecological surgery - a systematic review and meta-analysis.

Introduction: Acute kidney injury (AKI) is an abruptly occurring loss of renal function, which includes both kidney injury and kidney impairment. It is associated with mortality and morbidity due to the increased risk of developing chronic kidney disease. The aim of this systematic review and meta-analysis was to determine the incidence of post-operative AKI in gynaecological patients without pre-existing kidney injury.

[Mental health after ectopic pregnancy].

Ectopic pregnancy results in an urgent, sometimes lifethreatening condition and always leads to pregnancy loss. We conducted a literature search on mental health after ectopic pregnancy. The level of anxiety, depression, posttraumatic stress and grief was high, comparable to the level after miscarriage.

Microbreaks in Laparoscopic Appendectomy have No Effect on Surgeons' Performance and Well-being.

Background: Musculoskeletal fatigue and pain as a consequence of performing surgery is found in 70%-87% of surgeons. The aim of this study was to examine the effect of microbreaks on surgeons' performance and well-being during laparoscopic appendectomy.

Materials And Methods: The study was a blinded randomized crossover trial.

[Posterior reversible encephalopathy syndrome - an MRI diagnosis often missed in pregnancy].

Posterior reversible encephalopathy syndrome (PRES) is a complex clinical condition with a wide clinical spectrum. In this report two cases illustrate two different onsets. The first patient presented with general seizures, whereas the other presented with symptoms of pre-eclampsia, which developed into sudden blindness.

[The use of chewing gum stimulates bowel motility after gynaecological surgery].

Post-operative ileus is a condition which occurs after abdominal surgery. The incidence of post-operative ileus after gynaecological surgery is estimated to be 10-15% (range: 5-25%). The highest rates occur after laparotomy.

No Circadian Variation in Surgeons' Ability to Diagnose Acute Appendicitis.

Objective: To examine if there were circadian variations in surgeons' ability to diagnose acute appendicitis.

Design: Retrospective database study of all patients admitted to an acute surgical procedure under the potential diagnosis of acute appendicitis in a 4-year period. The day was divided into 2 time intervals, day to evening hours (08:00-23:59) and night hours (00:00-07:59).

Test re-test reliability and construct validity of the star-track test of manual dexterity.

Objectives. We wished to determine test re-test reliability and construct validity of the star-track test of manual dexterity. Design.

Working night shifts affects surgeons' biological rhythm.

Background: Chronic sleep deprivation combined with work during the night is known to affect performance and compromise residents' own safety. The aim of this study was to examine markers of circadian rhythm and the sleep-wake cycle in surgeons working night shifts.

Methods: Surgeons were monitored prospectively for 4 days: pre call, on call, post call day 1 (PC1), and post call day 2 (PC2).

[Micropauses during surgery may benefit surgeons and patients].

Long working hours can lead to physical and mental fatigue. Surveys show that many surgeons suffer from musculoskeletal disorders. A method used to counter fatigue is frequent short pauses.

Decreased heart rate variability in surgeons during night shifts.

Background: Heart rate variability (HRV) has been used as a measure of stress and mental strain in surgeons. Low HRV has been associated with death and increased risk of cardiac events in the general population. The aim of this study was to clarify the effect of a 17-hour night shift on surgeons' HRV.

The impact of sleep deprivation on surgeons' performance during night shifts.

The median incidence of adverse events that may result in patient injury is a total of 9% of all in-hospital admissions. In order to reduce this high incidence initiatives are continuously worked on that can reduce the risk of patient harm during admission by strengthening hospital systems. However, the influence of physicians' shift work on the risk on adverse events in patients remains controversial.

Admission medical records made at night time have the same quality as day and evening time records.

Introduction: A thorough and accurate admission medical record is an important tool in ensuring patient safety during the hospital stay. Surgeons' performance might be affected during night shifts due to sleep deprivation. The aim of the study was to assess the quality of admission medical records during day, evening and night time.

Laparoscopic skills and cognitive function are not affected in surgeons during a night shift.

Objective: To monitor surgeons' performance and cognition during night shifts.

Design: Surgeons were monitored before call and on call (17-hour shift). Psychomotor performance was assessed by laparoscopic simulation and cognition by the d2 test of attention.

[Uncertain if physicians' shift work causes patient harm].

The role of physicians' shift work in adverse events causing patient harm is not clear. However, extended shifts reduce psychomotor performance and cognition in daytime after a 24-hour shift. The incidence and preventability of adverse events in Denmark are comparable to other Western countries, despite the fact that Danish physicians do not work extended hours.

Analgesic effects of melatonin: a review of current evidence from experimental and clinical studies.

Melatonin is an endogenous indoleamine, produced mainly by the pineal gland. Melatonin has been proven to have chronobiotic, antioxidant, antihypertensive, anxiolytic and sedative properties. There are also experimental and clinical data supporting an analgesic role of melatonin.

Conservatively treated perforation of the neovagina in a male to female transsexual patient.

An unknown number of patients have had male to female gender transformation. Various surgical techniques have been employed to construct the neovagina. The more traditional techniques include inverted penile grafts and vascular pedicle grafts, but also the small bowel and sigmoid colon have been used.