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Background Methods Results Conclusion Inadequate pain relief with moderate to severe pain remains a challenge after cesarean section and may significantly impair postoperative recovery. However, detailed assessment on the timing of severe pain, opioid consumption, influence on activities such as mobilization, breastfeeding, and caring for the infant are difficult to conduct, especially after discharge. Short message services (SMS)‐based questionnaires may offer a low‐cost way of providing such data but with the risk of insufficient response rates. We assessed the feasibility of collecting detailed, prospective data on postoperative pain and recovery during the initial hours and days following cesarean section using SMS‐based questionnaires.Prospective Danish single‐center cohort study involving elective cesarean sections under spinal anesthesia with fentanyl and bupivacaine. The postoperative pain regimen consisted of paracetamol, NSAID and oral morphine by request. Patients received an SMS‐based questionnaire at 6, 12, 18, 24, and 48 h postoperatively, as well as on days 7 and 30. Primary outcome: Response rate and time from receiving the SMS to completion of the questionnaires. Secondary outcomes: Opioid consumption and Patient Reported Outcomes Measures on pain and recovery.From December 2022 to June 2023; 100 patients were included. The response rate was 78% at 6 h postoperatively, decreasing to 63% at 24 h. The median response time from receiving to answering the SMS‐based questionnaire at 6 h after cesarean section was 23 min (IQR 2–72), decreasing to 20 min (IQR 2–78) after 24 h. Severe pain, corresponding to a Numeric Rating Scale (NRS) score >6, was reported by 57% (95% CI 65–84) at 6 h, decreasing to 28% (95% CI 34–58) at 24 h. Median opioid consumption within the first 24 h was 30 mg (IQR 20–50).SMS‐based questionnaires on Patient Reported Outcome Measures are a feasible and cost‐effective way of prospectively collecting frequent data with acceptable response rates, even shortly after cesarean section. Secondarily 66% of patients reported severe pain during the first 24 h following cesarean section, with the highest pain scores within the initial 12 h. Future studies should focus on optimizing pain‐management within this timeframe. [ABSTRACT FROM AUTHOR]

Background: E‐learning is increasingly used in postgraduate medical education. Its numerous benefits include an enhanced learning experience through learning style individualisation, interactive elements, and assessment through tests and quizzes. Current meta‐analyses conclude that the overall effectiveness of e‐learning is comparable to traditional teaching modalities. However, studies demonstrating its benefits are heterogeneous and of varying quality. This randomised controlled trial aims to investigate whether contemporary e‐learning completed prior to a course in obstetric anaesthesia prepares the course participants better than self‐study of written course material. Methods: A randomised controlled trial allocated second‐year resident anaesthetists to receive either e‐learning in postpartum haemorrhage and written course material in preeclampsia or e‐learning in preeclampsia and written course material in postpartum haemorrhage, prior to a compulsory course in obstetric anaesthesia. The primary outcome was knowledge after completion of e‐learning before the course, assessed by type X multiple‐choice questions with a score ranging from zero to 35. The secondary outcomes were anxiety level before course simulations, performance during course simulations, and knowledge four and 12 weeks after the course. Results: The per protocol analysis of the primary outcome included 45 participants and demonstrated a mean difference of 1.8 (95% CI 0.7–2.9; p =.002) in knowledge after completion of e‐learning before the course, in favour of e‐learning compared to written course material. There were no statistically significant differences in the secondary outcomes. Conclusion: This blinded parallel group randomised controlled trial found a numerically small but statistically significant difference in knowledge favouring e‐learning over written course material. [ABSTRACT FROM AUTHOR]

The article presents a study on the development of acute respiratory distress syndrome (ARDS) in Maniitsoq, Greenland. The study showed that inhalation of aerosols of surface active substances is a known risk factor for the development of ARDS. The country's healthcare system has a set-up that makes it capable of managing acute situations even up to a larger scale.

Introduction: The aim of the present nationwide Danish cohort study was to examine the association between body mass index (BMI) and reoperation in patients who are sur-gically treated for perforated peptic ulcer (PPU)., Methods: This was a nationwide cohort study of all Danish patients who were surgically treated for benign gastric or duodenal PPU between 2011 and 2013., Outcome Measures: reoperation within 30 days of the primary surgical procedure and 90-day survival. The association between BMI and reoperation are presented as crude and adjusted odds ratios (OR) with 95% confidence intervals (CIs)., Results: A total of 726 patients were included. The median age was 69.5 years (range: 18.2-101.7 years), 51.4% were women (n = 373), 78.4% (n = 569) of the patients had at least one co-existing disease, and 47.5% (n = 345) were categorised as American Society of Anesthesiologists (ASA) class ≥ 3. Re-operative surgery was done in 124 patients (17.1%). No statistically significant adjusted association between underweight, overweight or obesity and re-operation was found (adjusted OR (95% CI): 0.456 (0.181-1.148), 1.468 (0.857-2.517), and 1.314 (0.663-2.601), respectively). Patients undergoing reoperative surgery had a statistically significantly lower crude 90-day survival than patients without need of reperative surgery; 63.9% (83/124) versus 75.9% (457/602), p = 0.037., Conclusion: In the present nationwide cohort study of PPU patients, no statistically significantly adjusted correlation between BMI and re-operation rates was found. Patients undergoing reoperative surgery had a decreased 90-day survival., Funding: not relevant., Trial Registration: not relevant.