Avian leukosis virus subgroup - J as a contaminant in live commercially available poultry vaccines distributed in Nigeria.

Globally, vaccines are used to prevent and control the menace of infectious diseases in livestock with some reported to be inadvertently contaminated with extraneous agents (EAs). With the aim of screening and characterizing for some selected EAs, 44 live viral poultry vaccines were randomly selected based on availability. The vaccines comprised 14 manufacturers in 10 different countries including Nigeria were screened by Polymerase Chain Reaction. In 9% (4/44) of the vaccines, contamination with only avian leukosis virus (ALV) subgroup J (ALV-J) was recorded. Other exogenous ALV subgroups, chicken infectious anemia and infectious laryngotracheitis viruses were absent. The EAs was found in infectious bursal disease (n = 1), Fowlpox (n = 2) and Mareks disease (n = 1) vaccines. Phylogenetic analysis of the ALV-J env gene showed clustering with contemporary group I and II. The result underscores the importance of screening vaccines to avoid the introduction and spread of EAs that could pose a threat to poultry production.

Social network investigation of a syphilis outbreak in Ottawa, Ontario.

BACKGROUND: The incidence of syphilis in Ottawa, Ontario, has risen substantially since 2000 to six cases per 100,000 in 2003, again to nine cases per 100,000 in 2007, and recently rose to 11 cases per 100,000 in 2010. The number of cases reported in the first quarter of 2010 was more than double that in the first quarter of 2009. OBJECTIVE: In May 2010, the Ontario Ministry of Health and Long Term Care requested the assistance of the Field Epidemiology Program to describe the increase in infectious syphilis rates and to identify social network sources and prevention messages. METHODS: Syphilis surveillance data were routinely collected from January 1, 2009 to July 15, 2010, and social networks were constructed from an enhanced social network questionnaire. Univariate comparisons between the enhanced surveillance group and the remaining cases from 2009 on non-normally distributed data were conducted using Kruskal-Wallis tests and χ(2) tests. RESULTS: The outbreak cases were comprised of 89% men. Seventeen of the 19 most recent cases consented to answer the questionnaire, which revealed infrequent use of condoms, multiple sex partners and sex with a same-sex partner. Information regarding social venues where sex partners were met was plotted together with sexual partnerships, linking 18 cases and 40 contacts, representing 37% of the outbreak population and connecting many of the single individuals and dyads. CONCLUSION: Uncovering the places sex partners met was an effective proxy measure of high-risk activities shared with infected individuals and demonstrates the potential for focusing on interventions at one named bar and one Internet site to reach a high proportion of the population at risk.

HISTORIQUE: L'incidence de syphilis à Ottawa, en Ontario, a beaucoup augmenté depuis 2000, passant de six cas sur 100 000 habitants en 2003 à neuf cas sur 100 000 habitants en 2007, puis à 11 cas sur 100 000 habitants en 2010. Le nombre de cas signalés pendant le premier trimestre de 2010 a plus que doublé par rapport à celui du premier trimestre de 2009. OBJECTIF: En mai 2010, le ministère de la Santé et des Soins de longue durée de l'Ontario a demandé l'aide du Programme canadien d'épidémiologie de terrain pour décrire l'augmentation du taux de syphilis infectieuses, en déterminer l'origine dans les réseaux sociaux et établir les messages de prévention. MÉTHODOLOGIE: Les chercheurs ont colligé systématiquement les données de surveillance sur la syphilis entre le 1er janvier 2009 et le 15 juillet 2010 et en ont établi les réseaux sociaux à partir d'un questionnaire amélioré sur les réseaux sociaux. Au moyen du test de Kruskal-Wallis et des tests du chi carré, ils ont effectué des comparaisons univariées des données non distribuées normalement entre le groupe de surveillance améliorée et les autres cas de 2009. RÉSULTATS: Les cas d'éclosion se composaient de 89 % d'hommes. Dix-sept des 19 cas les plus récents ont consenti à répondre au questionnaire, qui a révélé un usage peu fréquent du condom, de multiples partenaires sexuels et des relations sexuelles avec des partenaires de même sexe. Les chercheurs ont transcrit sur un graphique l'information relative aux lieux où les partenaires sexuels se sont rencontrés, ce qui a permis de relier 18 cas et 40 contacts, soit 37 % de la population de l'éclosion, et d'associer de nombreux individus uniques et de dyades. CONCLUSION: La découverte des lieux où les partenaires sexuels se sont rencontrés s'est révélée une mesure indirecte efficace des activités à haut risque partagées avec des personnes infectées et a démontré le potentiel d'intervenir seulement dans un bar précis et un site Internet donné pour joindre une forte proportion de la population à risque.

First report of co-infections of Marek's disease virus and chicken infectious anaemia virus in poultry flocks in Nigeria.

Marek's disease (MD) and chicken infectious anaemia (CIA) are viral immunosuppressive diseases of poultry caused by the MD virus (MDV) and CIA virus (CIAV) respectively. Despite vaccination against MD, the incidence of the disease in vaccinated poultry flocks in Nigeria persists. However, underlying factors like co-infection with CIAV have not been investigated in the country. This study was designed to investigate possible co-infections of MDV and CIAV in poultry flocks in Nigeria. In 2016, tumorous tissue samples were collected from suspected cases of MD at necropsy in Jos, Plateau State, Nigeria. The samples collected were fixed in formalin for histopathological examination, genomic DNA was extracted from a second part and analysed by polymerase chain reaction (PCR), targeting the meq and VP1 genes of the MDV and CIAV, respectively. The histology results revealed that the cutaneous and proventricular lymphomas were characterized by large numbers of mononuclear cellular infiltrates admixed with heterophils. The PCR results revealed that MDV was detected in 66.7% (16/24), CIAV in 45.8% (11/24), and co-infections of MDV and CIAV were detected in 45.8% (11/24) of the samples analysed. In addition, co-infections of MD and CIA were recorded in 100% (6/6) and 27.7% (5/18) of broilers and layer/pullet' samples respectively. Phylogenetic analysis of the meq gene sequences revealed that the Nigerian MDV clusters with very virulent MDV from Egypt and Italy. While, CIAV sequences were genotype II and genotype III and clustered with CIAVs from Cameroon and China. This is the first report of co-infections of MD and CIA in Nigeria.

Immunological insights into COVID-19 in Southern Nigeria.

Introduction: One of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the global COVID-19 fatalities. The factors responsible for Nigeria's relatively low loss of life due to COVID-19 are unknown. Also, the correlates of protective immunity to SARS-CoV-2 and the impact of pre-existing immunity on the outcome of the COVID-19 pandemic in Africa are yet to be elucidated. Here, we evaluated the natural and vaccine-induced immune responses from vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria throughout the three waves of the COVID-19 pandemic in Nigeria. We also examined the pre-existing immune responses to SARS-CoV-2 from samples collected prior to the COVID-19 pandemic. Methods: We used spike RBD and N- IgG antibody ELISA to measure binding antibody responses, SARS-CoV-2 pseudotype assay protocol expressing the spike protein of different variants (D614G, Delta, Beta, Omicron BA1) to measure neutralizing antibody responses and nucleoprotein (N) and spike (S1, S2) direct ex vivo interferon gamma (IFNγ) T cell ELISpot to measure T cell responses. Result: Our study demonstrated a similar magnitude of both binding (N-IgG (74% and 62%), S-RBD IgG (70% and 53%) and neutralizing (D614G (49% and 29%), Delta (56% and 47%), Beta (48% and 24%), Omicron BA1 (41% and 21%)) antibody responses from symptomatic and asymptomatic survivors in Nigeria. A similar magnitude was also seen among vaccinated participants. Interestingly, we revealed the presence of preexisting binding antibodies (N-IgG (60%) and S-RBD IgG (44%)) but no neutralizing antibodies from samples collected prior to the pandemic. Discussion: These findings revealed that both vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria make similar magnitude of both binding and cross-reactive neutralizing antibody responses. It supported the presence of preexisting binding antibody responses among some Nigerians prior to the COVID-19 pandemic. Lastly, hybrid immunity and heterologous vaccine boosting induced the strongest binding and broadly neutralizing antibody responses compared to vaccine or infection-acquired immunity alone.

Financial impact of sheeppox and goatpox and estimated profitability of vaccination for subsistence farmers in selected northern states of Nigeria.

Sheeppox and goatpox (SGP) are important transboundary diseases, endemic in Nigeria, causing severe clinical manifestations, impacting production, and resulting in economic losses. Vaccination is an effective control measure against SGP in endemic countries but is not currently implemented in Nigeria. This study aimed to estimate SGP financial impact and assess economic viability of SGP vaccination at the herd and regional level under different scenarios in Northern Nigeria. Integrated stochastic production and economic herd models were developed for transhumance and sedentary herds. Models were run for two disease scenarios (severely and slightly affected) and with and without vaccination, with data parameterisation from literature estimates, field survey and authors' experience. Herd-level net financial impact of the disease and its vaccination was assessed using gross margin (GM) and partial budget analyses. These were then used to assess regional financial impact of disease and profitability of a 3-year vaccination programme using a cost-benefit analysis. The regional-analysis was performed under 0 %, 50 % and 100 % government subsidy scenarios; as a standalone programme or in combination with other existing vaccination programmes; and for risk-based and non-risk-based intervention. Median SGP losses per reproductive female were £27 (90 % CI: £31-£22), and £5 (90 % CI: £7-£3), in sedentary, and £30 (90 % CI: £41-21), and £7 (90 % CI: £10-£3), in transhumance herds, for severely and slightly affected scenarios respectively. Selling animals at a reduced price, selling fewer young animals, and reduced value of affected animals remaining in the herd were the greatest contributors to farmer's SGP costs. SGP-affected herds realised a GM reduction of up to 121 % in sedentary and 138 % in transhumance. Median estimated regional SGP cost exceeded £24 million. Herd-level median benefits of vaccination per reproductive female were £23.76 (90 % CI: £19.28-£28.61), and £4.01 (90 % CI: £2.36-£6.31), in sedentary, and £26.85 (90 % CI: £17.99-£37.02) and £7.45 (90 % CI: £3.47-£15.14) in transhumance herds, in severely and slightly affected scenarios, respectively. Median benefit: cost ratio (BCR) for severely affected herds at 50% subsidies was 6.62 (90% CI: 5.30-8.90) for sedentary, and 5.14 (90% CI: 3.31-13.81) for transhumance herds. The regional SGP vaccination standalone programme BCR: 7-27, regional SGP vaccination with existing vaccination programme BCR: 7-228 and vaccinating high-risk areas BCR: 19-439 were found to be economically viable for all subsidy levels explored. Vaccinating low-risk areas only realised benefits with 100 % of government subsidies. This study further increases understanding of SGP's impact within Northern Nigeria and demonstrates vaccination is an economically viable control strategy at the herd-level and also regionally, depending on the strategy and government subsidy levels considered.

Household and animal factors associated with sheeppox and goatpox sero-prevalence and identification of high-risk areas in selected States of northern Nigeria.

Sheeppox and goatpox (SGP) are transboundary, highly contagious diseases affecting sheep and goats with characteristic clinical signs. SGP affect populations of small ruminants in Africa, Asia and the Middle East and, as a result, threaten farmers' livelihoods. Despite their importance, studies looking at factors that increase the risk of sheeppox-virus (SPPV) and goatpox-virus (GTPV) exposure and infection are limited. A cross-sectional study was conducted in three states of Northern Nigeria (Bauchi, Kaduna and Plateau) to determine the sero-prevalence and spatial patterns of SGP, and identify risk factors for SPPV/GTPV exposure at animal and household level. Sera samples were collected from 1,800 small ruminants from 300 households. Data on putative risk factors were collected using a standardised questionnaire. Twenty-nine small ruminants were sero-positive to SGP - apparent weighted sero-prevalence 2.0 %; 95 % C.I. 1.1-.3.0 %. Sero-positive animals came from 19 (6.3 %) households. Analysis of the questionnaire showed that a fifth (20.3 %) of farmers claimed to have experienced SGP outbreaks previously in their flocks, with 33 (1.8 %) of the individual animals sampled in this study reported to have had clinical signs. At animal level, the odds of being sero-positive were higher in older animals (>24months; OR = 8.0, p = 0.008 vs ≤24 months) and small ruminants with a history of clinical SGP (OR = 16.9, p = 0.01). Bringing new small ruminants into the household and having a history of SGP in the flock were the main factors identified at household level. Households were less likely to be sero-positive if the time between bringing animals into the household and sampling was over a year (PR = 0.31, p = 0.05), while households with a history of SGP were more likely to be sero-positive regardless of the timeframe. Important spatial heterogeneity was found. The Bayes smooth rate ranged from 0.06 to 4.10 % across local government areas (LGA), with LGA in the north-east or north-west of the study area identified as hot-spots for SGP exposure. Results from this study shed new light on the understanding of SGP epidemiology and provide key inputs to design risk-based surveillance and intervention programmes in the area.

Lemur social behavior and primate intelligence.

Our human intellect has resulted from an enormous leap in capacity above the level of monkeys and apes. Earlier, though, Old and New World monkeys' intelligence outdistanced that of other mammals, including the prosimian primates. This first great advance in intelligence probably was selected through interspecific competition on the large continents. However, even at this early stage, primate social life provided the evolutionary context of primate intelligence. Two arguments support this conclusion. One is ontogenetic: modern monkeys learn so much of their social behavior, and learn their behavior toward food and toward other species through social example. The second is phylogenetic: some prosimians, the social lemurs, have evolved the usual primate type of society and social learning without the capacity to manipulate objects as monkeys do. It thus seems likely that the rudiments of primate society preceded the growth of primate intelligence, made it possible, and determined its nature.

Evaluation of the pharmaceutical quality of some quinine preparations sold in Nigeria.

OBJECTIVE: The purpose of this study was to determine the pharmaceutical quality of quinine preparations sold in Nigerian markets. MATERIALS AND METHODS: The organoleptic and physicochemical properties of quinine tablets, as well as oral liquids and parenteral quinine preparations, were assessed according to British Pharmacopoeia (BP) and unofficial standards as recommended by the manufacturers. RESULTS: Of the 6 brands of tablets assessed, 4 passed the uniformity of content test and 5 the disintegration test, but only 2 the dissolution test. The pH of 2 of the 6 brands of oral liquid preparations met BP standards, while only 1 oral liquid met the BP standard for percentage content. The assay further demonstrated that 4 brands of the parenteral preparations met BP standards for quinine content. All the parenteral preparations were found to be sterile. CONCLUSION: Quinine preparations sold in Nigeria varied considerably in their pharmaceutical quality. A strict check of the quality of brands of quinine by regulatory agencies and distributors before they are sold to the public is therefore recommended.

Combining social network analysis and cluster analysis to identify sexual network types.

Increases in the rates of sexually transmitted infections (STIs) suggest that control programmes may not be effectively targeting diverse subpopulations. The objective of this investigation was to examine STI transmission within different groups, using both social network analysis and cluster analysis. Routine partner notification data were analysed from individuals diagnosed with, or exposed to an STI in Manitoba. Groups were identified and characterized. Three different clusters of groups were identified, comprised of demographically and clinically distinct individuals. A greater understanding of disease transmission patterns within these groups will aid in the development of targeted education and prevention programmes for all STIs.

Challenges in collecting clinical samples for research from pregnant women of South Asian origin: evidence from a UK study.

OBJECTIVE: To recruit South Asian pregnant women, living in the UK, into a clinicoepidemiological study for the collection of lifestyle survey data and antenatal blood and to retain the women for the later collection of cord blood and meconium samples from their babies for biochemical analysis. DESIGN: A longitudinal study recruiting pregnant women of South Asian and Caucasian origin living in the UK. SETTING: Recruitment of the participants, collection of clinical samples and survey data took place at the 2 sites within a single UK Northern Hospital Trust. PARTICIPANTS: Pregnant women of South Asian origin (study group, n=98) and of Caucasian origin (comparison group, n=38) living in Leeds, UK. RESULTS: Among the participants approached, 81% agreed to take part in the study while a 'direct approach' method was followed. The retention rate of the participants was a remarkable 93.4%. The main challenges in recruiting the ethnic minority participants were their cultural and religious conservativeness, language barrier, lack of interest and feeling of extra 'stress' in taking part in research. The chief investigator developed an innovative participant retention method, associated with the women's cultural and religious practices. The method proved useful in retaining the participants for about 5 months and in enabling successful collection of clinical samples from the same mother-baby pairs. The collection of clinical samples and lifestyle data exceeded the calculated sample size required to give the study sufficient power. The numbers of samples obtained were: maternal blood (n=171), cord blood (n=38), meconium (n=176), lifestyle questionnaire data (n=136) and postnatal records (n=136). CONCLUSIONS: Recruitment and retention of participants, according to the calculated sample size, ensured sufficient power and success for a clinicoepidemiological study. Results suggest that development of trust and confidence between the participant and the researcher is the key to the success of a clinical and epidemiological study involving ethnic minorities.

Quantitation of isoprenaline-induced changes in the ventricular myocardium.

Small doses of isoprenaline sulphate given intermittently produce a characteristic cardiopathy consisting of subendocardial scarring and myocardial hypertrophy. A morphometric technique was successfully applied to the quantitation of these changes. This technique improves the use of the isoprenaline model for the study of cardiac necrosis as statistical analysis can be applied and objective comparisons made. No hypertrophy was seen in the absence of myocardial necrosis which suggests that it is at least in part compensatory.

Polymers for biodegradable medical devices. II. Hydroxybutyrate-hydroxyvalerate copolymers: hydrolytic degradation studies.

The hydrolytic degradation of poly(hydroxybutyrate) together with a series of hydroxybutyrate-hydroxyvalerate copolymers has been studied. The effects of copolymer composition and molecular weight are presented together with the results of varying pH and temperature on the degradation rate. Degradation has been monitored by weight loss and water uptake measurements together with goniophotometric, surface energy and scanning electron microscopic studies. Some comparisons with the more widely used so-called 'biodegradable' polymers, poly(glycolic acid), poly(dioxanone) and the glycolic-lactic acid (90:10) copolymers are presented together with the effect of blood plasma on the degradation process.

Polymers for biodegradable medical devices. VI. Hydroxybutyrate-hydroxyvalerate copolymers: accelerated degradation of blends with polysaccharides.

The hydrolytic degradation of poly(hydroxybutyrate)-poly(hydroxyvalerate) (PHB-PHV) copolymers in the form of blends with the polysaccharides amylose, dextran, dextrin and sodium alginate, has been studied under a range of conditions (pH 2.3, 7.4 and 10.6 and at 37 degrees C and 70 degrees C). The hydrolytic degradation of the PHB-PHV copolymers was found to be dramatically affected by the presence of polysaccharides. Its progress was characterized by an initial increase in the wet weight, with concurrent decrease in the dry weight as the polysaccharides eroded from the matrix. Surface energy measurements and goniophotometry proved to be particularly useful in monitoring this stage of the degradation process. The concurrent increase in internal porosity leads to the eventual collapse of the matrix, a process which occurs, but less rapidly, in the degradation of the unblended PHB-PHV copolymers. Information obtained from molecular weight and crystallinity studies enabled a comprehensive profile of the overall degradation process to be built up.

[Lesions of the circumflex nerve. Apropos of 19 cases]. / Les lésions du nerf circonflexe. A propos de 19 cas.

The authors studied a series of 19 lesions of the circumflex nerve either isolated (14 cases) or in association with a lesion of the suprascapular or musculocutaneous nerves. All were treated surgically. One was caused by a gunshot wound, the others were due to traction on the axillary region, and associated with anterior dislocation of the shoulder in five cases, a fracture of the humerus in two cases and a fracture of the clavicle in one case. Despite complete paralysis of the deltoid, active abduction was often possible. The operation took place 4 to 6 months after injury. In the 14 cases of isolated lesions of the circumflex nerve, the nerve was approached both anteriorly and posteriorly. It was always found to be divided and could be repaired by grafting in 10 cases, and secondary suture in one case. On three occasions the lesion was too distal and could not be repaired. When repair was possible, two excellent and eight good results were obtained, one case being too recent for follow up. In cases of associated lesions of the circumflex and suprascapular nerves, the repair of the latter was not possible and results were poor. In contrast, in cases of associated lesions of the circumflex and musculocutaneous nerves, repair was possible with satisfactory results at the level of the deltoid and biceps. These results indicate that an earlier diagnosis would allow a repair and a more satisfactory condition of lesions which are close to the motor end plates and of relatively good prognosis.

Indigenous mental health care among Gurkha soldiers based in the United Kingdom.

This paper looks at the concept of the indigenous healer and draws on experiences of those closely involved with the progress of one soldier who, after feeling unwell, believed he was destined to become a shaman. Initially treated by Western methods, which failed to resolve his situation, he returned to Nepal to consult with the local traditional healers. He spent six weeks in Nepal and was seen by three different types of local shamans. Upon his return to Britain he claimed to be free of symptoms and returned to his normal military duties.

Extracting drug mechanism and pharmacodynamic information from clinical electroencephalographic data using generalised semi-linear canonical correlation analysis.

Conventional analysis of clinical resting electroencephalography (EEG) recordings typically involves assessment of spectral power in pre-defined frequency bands at specific electrodes. EEG is a potentially useful technique in drug development for measuring the pharmacodynamic (PD) effects of a centrally acting compound and hence to assess the likelihood of success of a novel drug based on pharmacokinetic-pharmacodynamic (PK-PD) principles. However, the need to define the electrodes and spectral bands to be analysed a priori is limiting where the nature of the drug-induced EEG effects is initially not known. We describe the extension to human EEG data of a generalised semi-linear canonical correlation analysis (GSLCCA), developed for small animal data. GSLCCA uses data from the whole spectrum, the entire recording duration and multiple electrodes. It provides interpretable information on the mechanism of drug action and a PD measure suitable for use in PK-PD modelling. Data from a study with low (analgesic) doses of the µ-opioid agonist, remifentanil, in 12 healthy subjects were analysed using conventional spectral edge analysis and GSLCCA. At this low dose, the conventional analysis was unsuccessful but plausible results consistent with previous observations were obtained using GSLCCA, confirming that GSLCCA can be successfully applied to clinical EEG data.

Does diisocyanate exposure result in neurotoxicity?

CONTEXT: Diisocyanates have been associated with respiratory and dermal sensitization. Limited number of case reports, and a few case studies, media, and other references suggest potential neurotoxic effects from exposures to toluene diisocyanate (TDI), 1,6 hexamethylene diisocyanate (HDI), and methylene diisocyanate (MDI). However, a systematic review of the literature evaluating the causal association on humans does not exist to support this alleged association. OBJECTIVE: To perform systematic review examining the body of epidemiologic evidence and provide assessment of causal association based on principles of the Sir Austin Bradford Hill criteria or considerations for causal analysis. METHODS: A comprehensive search of public databases for published abstracts, case reports, cross-sectional surveys, and cohort studies using key search terms was conducted. Additional searches included regulatory reviews, EU IUCLID and EU Risk Assessment databases, and unpublished reports in the International Isocyanate Institute database. An expert panel consisting of physicians, toxicologists, and an epidemiologist critically reviewed accepted papers, providing examination of epidemiologic evidence of each report. Finally, the Hill criteria for causation were applied to the summative analysis of identified reports to estimate probability of causal association. RESULTS: Twelve papers reporting exposed populations with a variety of neurological symptoms or findings suitable for analysis were identified, including eleven case or case series reports, and one cross-sectional study. Three papers reported on the same population. Each of the papers was limited by paucity of diisocyanate exposure estimates, the presence of confounding exposures to known or suspected neurotoxicants, a lack of objective biological measures of exposure or neurotoxic effects, and lack of relative strength of association measures. Additionally, reported health symptoms and syndromes lacked consistency or specificity. No plausible mechanism of toxicity was found. Application of a predictive mathematical model for determining probability of causal association for neurotoxicity was calculated to be 21%. CONCLUSION: There is insufficient evidence for a causal association of neurotoxic effects and diisocyanate exposure based on lack of evidence in all categories of the Hill criteria for causality except for temporal association of reported symptoms and alleged exposure. Future reports should attempt to address more rigorous exposure assessment and control for confounding exposures.

Anaesthesia for robotic gynaecological surgery.

Robotic surgery is gaining widespread popularity due to advantages such as reduced blood loss, reduced postoperative pain, shorter hospital stay and better visualisation of fine structures. Robots are being used in urological, cardiac, thoracic, orthopaedic, gynaecological and general surgery. Robotic surgery received US Food and Drug Administration approval for use in gynaecological surgery in 2005. The various gynaecological robotic operations being performed are myomectomy, total and supracervical hysterectomy, ovarian cystectomy, sacral colpopexy, tubal reanastomosis, lymph node dissection, surgery of retroperitoneal ectopic pregnancy, Moskowitz procedure and endometriosis surgery. The anaesthetic considerations include difficult access to the patient intraoperatively, steep Trendelenburg position, long surgical duration and the impact of pneumoperitoneum. We highlight the complications encountered in these surgeries and methods to prevent these complications. Robotic gynaecological surgery can be safely performed after considering the physiological effects of the steep Trendelenburg position and of pneumoperitoneum. The benefits of the surgical procedure should be weighed against the risks in patients with underlying cardiorespiratory problems.