[Does the anesthesiologist sleep soundly?]. / Spava li anesteziolog cvrsto?

Working in night shifts influences human health, mood, and cognitive functions. Anesthesia residents and consultants work in long shifts that include the night. Changes of cognitive functions may diminish the quality of anesthesiologist's work, increase the number of errors, and endanger the patient. Changes of biological rhythms can influence health of the anesthesiologist himself. The alterations in circulation, metabolism, memory, fine motor control, mood and attention have been recorded. After night work, the possibility of car accident for an anesthesiologist is higher. Attempts have been made to reduce negative influences of night work by shortening the number of working hours during the week. The debate about this step is vivid and still present. From this viewpoint, the most interesting aspects are the quality of educational process, the number of errors in practical work, and the quality of health care. After shortening of working hours, there are no clear indicators of the positive effects in any of these fields. Shortening of the working week is part of 'the culture of safety' in anesthesiology.

[Neurological disorders in pregnancy]. / Neuroloski poremecaji u trudnoci.

Preeclampsia is characterized by hypertension, peripheral edema and proteinuria, but very often also includes neurologic complications. Neurologic complications of severe preeclampsia are indentical to those of hypertensive encephalopathy. The most common neurologic symptoms are headache, vomiting, mental disorders, visual disturbances, sensorimotor deficits and seizures. Endothelial cell dysfunction is the main cause of multiorgan failure. It is of utmost importance to recognize these symptoms and initiate apropriate therapy. Systemic blood presure must not exceed the cerebrovascular autoregulatory capacity. Serum magnesium level is significantly decreased in pregnant women with severe preeclampsia and cerebral edema. Magnesium has been shown to be effective in reducing the occurrence of seizures in preeclampsia by decreasing neuronal excitability, protecting the endothelium against free radicals and reducing cerebral perfusion.

Persistent oxidative stress after myocardial infarction treated by percutaneous coronary intervention.

Acute myocardial infarction causing cardiac ischemia is responsible for the majority of cardiac related deaths. Medical interventions that ensure rapid reperfusion, such as percutaneous coronary intervention, are aimed to allow myocardial re-oxygenation. However, this generates reactive oxygen species, resembling ischemia-reperfusion type of injury based on oxidative stress. In the present study we monitored dynamic changes of total serum peroxides, total antioxidant capacity and soluble intercellular adhesion molecule-1 as well as the titer of antibodies against oxidized low-density lipoproteins in the blood during the convalescence period of 32 patients with acute myocardial infarction treated by percutaneous coronary intervention. Samples were taken at admittance and at two hours, four hours, three days and seven days following percutaneous coronary intervention. Total antioxidant capacity dropped to 82% (p < 0.05). The titer of antibodies against oxidized low-density lipoproteins transiently decreased within the first three days, and increased afterwards. The values of serum peroxides and soluble intercellular adhesion molecule-1 increased continuously in respect to the initial levels reaching the maximum at the time of release from hospital. These findings indicate a persistent oxidative stress that might be associated with intravascular inflammation in patients during convalescence and release from hospital.