Efficacy of a pre-operative anaemia clinic in patients undergoing elective abdominal cancer surgery.

Background: Pre-operative iron deficiency anaemia (IDA) is common in patients undergoing elective major abdominal surgery and is associated with increased risk of perioperative complications. However, widespread implementation of pre-operative anaemia management is lacking. Guidelines recommend investigation of anaemia preferably 4-6 weeks before surgery to allow time for correction.

Impact of Albumin on Coagulation Competence and Hemorrhage During Major Surgery: A Randomized Controlled Trial.

For patients exposed to a massive blood loss during surgery, maintained coagulation competence is important. It is less obvious whether coagulation competence influences bleeding during elective surgery where patients are exposed to infusion of a crystalloid or a colloid. This randomized controlled trial evaluates whether administration of 5% human albumin (HA) or lactated Ringer solution (LR) affects coagulation competence and in turn blood loss during cystectomy due to bladder cancer.

Plasma pro-atrial natriuretic peptide to indicate fluid balance during cystectomy: a prospective observational study.

Objectives: During surgery the volume of administered fluid is debated. Pro-atrial natriuretic peptide (proANP) is released by atrial distension, and we evaluated the relationship between changes in proANP associated with perioperative fluid balance.

Design: Prospective observational study.

Coagulation competence for predicting perioperative hemorrhage in patients treated with lactated Ringer's vs. Dextran--a randomized controlled trial.

Background: Perioperative hemorrhage may depend on coagulation competence and this study evaluated the influence of coagulation competence on blood loss during cystectomy due to bladder cancer.

Methods: Forty patients undergoing radical cystectomy were included in a randomized controlled trial to receive either lactated Ringer's solution or Dextran 70 (Macrodex ®) that affects coagulation competence.

Results: By thrombelastography evaluated coagulation competence, Dextran 70 reduced "maximal amplitude" (MA) by 25 % versus a 1 % reduction with the administration of lactated Ringer's solution (P <0.

Tracheal intubation with a flexible fibreoptic scope or the McGrath videolaryngoscope in simulated difficult airway scenarios: a randomised controlled manikin study.

Background: Flexible fibreoptic endoscopic (FFE) intubation is considered the 'gold-standard' when difficult airway management is anticipated. Several videolaryngoscopes have been developed to facilitate intubation by laryngoscopy.

Objective: The aim of the study was to compare the performance of the McGrath series 5 videolaryngoscope (McGrath videolaryngoscope) and the FFE for tracheal intubation in manikins with a simulated difficult airway, hypothesizing that the McGrath videolaryngoscope intubation would prove faster than FFE intubation.

Hydroxyethyl starch reduces coagulation competence and increases blood loss during major surgery: results from a randomized controlled trial.

Objective: This study evaluated whether administration of hydroxyethyl starch (HES) 130/0.4 affects coagulation competence and influences the perioperative blood loss.

Background: Artificial colloids substitute blood volume during surgery; with the administration of HES 130/0.

Does goal-directed fluid therapy affect postoperative orthostatic intolerance?: A randomized trial.

Background: Early mobilization is important for postoperative recovery but is limited by orthostatic intolerance (OI) with a prevalence of 50% 6 h after major surgery. The pathophysiology of postoperative OI is assumed to include hypovolemia besides dysregulation of vasomotor tone. Stroke volume-guided fluid therapy, so-called goal-directed therapy (GDT), corrects functional hypovolemia, and the authors hypothesized that GDT reduces the prevalence of OI after major surgery and assessed this in a prospective, double-blinded trial.

Transversus abdominis plane block or subcutaneous wound infiltration after open radical prostatectomy: a randomized study.

Background: Open radical retropubic prostatectomy (ORRP) is associated with moderate pain. We hypothesized that a transversus abdominis plane (TAP) block would reduce post-operative pain, morphine consumption and opioid-related side effects compared with wound infiltration and placebo in this population.

Methods: This was a randomized, double-blind and placebo-controlled study.

Orthostatic intolerance and the cardiovascular response to early postoperative mobilization.

Background: A key element in enhanced postoperative recovery is early mobilization which, however, may be hindered by orthostatic intolerance, that is, an inability to sit or stand because of symptoms of cerebral hypoperfusion as intolerable dizziness, nausea and vomiting, feeling of heat, or blurred vision. We assessed orthostatic tolerance in relation to the postural cardiovascular responses before and shortly after open radical prostatectomy.

Methods: Orthostatic tolerance and the cardiovascular response to sitting and standing were evaluated on the day before surgery and 6 and 22 h after operation in 16 patients.

Flow-related techniques for preoperative goal-directed fluid optimization.

Background: Improved postoperative outcome has been demonstrated by perioperative maximization of cardiac stroke volume (SV) with fluid challenges, so-called goal-directed therapy. Oesophageal Doppler (OD) has been the most common technique for goal-directed therapy, but other flow-related techniques and parameters are available and they are potentially easier to apply in clinical practice. The objective of this investigation was therefore to use OD for preoperative SV maximization and compare the findings with a Modelflow determined SV, with an OD estimated corrected flow time (FTc), with central venous oxygenation ( Svo2 ) and with muscle and brain oxygenation assessed with near infrared spectroscopy (NIRS).

Residents lack knowledge and practical skills in handling the difficult airway.

Background: Full-scale simulators have been developed in anaesthesia. We aimed at assessing Danish anaesthesia residents' knowledge and management of a standardized difficult airway situation in an advanced airway simulator. The reliability of the assessment was also determined.

[Nitric oxide inhalation therapy in patients with acute respiratory distress syndrome. A retrospective analysis].

Acute lung injury in the form of the acute respiratory distress syndrome (ARDS) continues to carry a high mortality. Recently, inhaled nitric oxide (NO) has been used in ARDS patients with severe hypoxaemia. We present a retrospective analysis concerning 33 ARDS patients treated with inhaled NO during a period of four years from 1994 to 1998.

[Mollaret's meningitis. A rare disease with a characteristic presentation].

We report a case of a 72-year-old woman, who within a six-year period had four episodes of Mollaret's meningitis. Lumbar punctures during each episode revealed moderate leukocytosis with large mononuclear cells. Characteristic manifestations and differential diagnosis are briefly reviewed.

Renal threshold for glucose in non-insulin-dependent diabetic patients.

Measurement of glycosuria is still widely used for home monitoring of glycaemia control in non-insulin-dependent diabetes (NIDDM). This method has been criticized because the renal threshold for glucose (RTglu) varies between subjects. In order to evaluate the validity of RTglu by measuring corresponding measurements of blood and urine glucose in NIDDM patients, we studied the blood/urine glucose relationship in 24 NIDDM patients.

[Alcohol consumption and organic damage. Views and attitudes of Danish patients and their relatives].

A total of 201 patients and their relatives in a hospital in Copenhagen participated in a structured interview investigation about their knowledge of the long-term effects of alcohol and their attitudes to restrictions. The majority approved of an upper limit for alcohol consumption within the recommended limits but a total of approximately 1/3 preferred a higher limit. Only 28% realised that there was a difference in how much alcohol women and men can tolerate.

Isolation and sequence analysis of a chalcone synthase cDNA of Matthiola incana R. Br. (Brassicaceae).

A cDNA clone (pcM12) of the chalcone synthase (CHS) of Matthiola incana R. Br. (Brassicaceae) was isolated from a cDNA library, sequenced and analysed.