Danish medical journal
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Danish medical journal · Sep 2014
Chronobiology, cognitive function and depressive symptoms in surgical patients.
Biological rhythms are essential for the regulation of many life processes. Disturbances of the circadian rhythm are known to affect human health, performance and well-being and the negative consequences are numerous and widespread. Cognitive dysfunction, fatigue, pain, sleep disturbances and mood disorders, such as anxiety and depression, are common problems arising around the time of surgery or in the course of a cancer diagnosis and subsequent treatment period. ⋯ The quantity, size and quality of trials investigating this question were not high and there was no clear evidence of an effect, although some studies were positive. In conclusion, further research is warranted with regard to the prophylactic effect and treatment effect of melatonin in depression, depressive symptoms, cognitive disturbances and symptom clusters of cancer patients in general. In addition, more hypothesis-generating studies with regard to the genetic heritability of POCD are needed.
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Danish medical journal · Sep 2014
Use of biomarker S100B for traumatic brain damage in the emergency department may change observation strategy.
The revised Scandinavian Neurotrauma Committee (SNC) guidelines on management of patients with head trauma include an option for measurement of S100B in peripheral blood with 100% sensitivity for neurosurgical intervention. A medical technology assessment was conducted to evaluate any impact of using S100B on the use of computed tomographies (CT) of the brain and admission for observation. ⋯ not relevant.
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Danish medical journal · Sep 2014
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. ⋯ Surgeons do feel an impact of sleep deprivation during night shifts, and their circadian rhythm is affected. Despite this, it appears that the surgeons are able to compensate for the effects of sleep loss. We did not find any results to support that sleep loss results in psychomotor or cognitive deterioration during a 17-hour night shift or that sleep deprivation during a night shift results in reduced patient safety.