In healthy men, levels of endothelial progenitor cells may be a surrogate biologic marker for vascular function and cumulative cardiovascular risk. These findings suggest that endothelial injury in the absence of sufficient circulating progenitor cells may affect the progression of cardiovascular disease.

Cardiovascular disease (CVD) due to atherosclerosis of the arterial vessel wall and to thrombosis is the foremost cause of premature mortality and of disability-adjusted life years (DALYs) in Europe, and is also increasingly common in developing countries.1 In the European Union, the economic cost of CVD represents annually E192 billion1 in direct and indirect healthcare costs. The main clinical entities are coronary artery disease (CAD), ischaemic stroke, and peripheral arterial disease (PAD). The causes of these CVDs are multifactorial. Some of these factors relate to lifestyles, such as tobacco smoking, lack of physical activity, and dietary habits, and are thus modifiable. Other risk factors are also modifiable, such as elevated blood pressure, type 2 diabetes, and dyslipidaemias, or non-modifiable, such as age and male gender. These guidelines deal with the management of dyslipidaemias as an essential and integral part of CVD prevention. Prevention and treatment of dyslipidaemias should always be considered within the broader framework of CVD prevention, which is addressed in guidelines of the Joint European Societies’ Task forces on CVD prevention in clinical practice.2 – 5 The latest version of these guidelines was published in 20075; an update will become available in 2012. These Joint ESC/European Atherosclerosis Society (EAS) guidelines on the management of dyslipidaemias are complementary to the guidelines on CVD prevention in clinical practice and address not only physicians [e.g. general practitioners (GPs) and cardiologists] interested in CVD prevention, but also specialists from lipid clinics or metabolic units who are dealing with dyslipidaemias that are more difficult to classify and treat.

This study was conducted to investigate the risk factors associated with peripartum hysterectomy in women who had either vaginal or cesarean delivery. The study subjects were women (n ϭ 101) who had a peripartum hysterectomy at the authors' institution from January 1986 to April 2001. Seventy-two of the 101 patients had delivered at Yonsei University Medical Center and 29 were referred from other hospitals. Of the total 31,044 deliveries at Yonsei during this time period, 11,924 were performed by cesarean section. Fifty-four of these women (0.45%) and 28 of the 19,080 who had a vaginal delivery (0.09%) underwent peripartum hysterectomy. Five of the 29 referred patients had a cesarean section and 24 had a vaginal delivery. The average time from delivery to hysterectomy was significantly longer in the vaginal group than in the cesarean section group (169 min vs. 49 min; P Ͻ.05). Also, women who had a vaginal delivery required significantly more blood (1908 ml) than those who had a cesarean section (1536 ml)(P Ͻ.05), although the average length of hospital stay was similar for both groups. Uterine atony was the most common indication for peripartum hysterectomy (42 of 101; 41.6%). Placenta previa accreta, placenta accreta, and placenta previa was the diagnosis in 23.8%, 16.7% and 11.9% of patients, respectively. Among the 29 women who had a previous cesarean section, the indications were uterine atony (n ϭ 10; 34.5%), placenta previa accreta (n ϭ 13; 44.8%), placenta previa (n ϭ 4; 13.8%), and placenta accreta (n ϭ 2; 6.9%). Blood loss was more highly associated with placenta previa accreta than with placenta previa or accreta alone (1734 ml vs. 16,58 ml and 1084 ml, respectively; P Ͻ.05). The only complications recorded were bladder injury in one woman with placenta previa, one disseminated intravascular coagulopathy in the placenta accreta group, and one case of sepsis among patients with placenta previa accreta. Of the 59 peripartum hysterectomies associated with cesarean section, 26 were in women undergoing elective cesarean section (44.1%) and 33 were after emergency cesarean section (55.9%). Blood loss was similar in both groups. The women who had emergency surgery experienced a higher complication rate than those undergoing elective cesarean section. Two patients sustained bladder injury, one had ureteral injury, one had bowel injury, one developed acute hepatitis, and one had disseminated intravascular coagulopathy. In the elective surgery group, there was a bladder laceration in one patient and another patient had disseminated intravascular coagulopathy. GYNECOLOGYVolume 58, Number 7 OBSTETRICAL AND GYNECOLOGICAL SURVEY ABSTRACT This paper presents the results of an investigation of the force required to insert a laparoscopic trocar into the abdominal cavity. Both disposable and reusable laparoscopic trocar systems were studied. Study subjects were 20 consecutive women who were scheduled to undergo routine diagnostic and laparoscopic surgery and were randomly selected for either the disposable trocar device...

Disclaimer. The ESC Guidelines represent the views of the ESC and were arrived at after careful consideration of the available evidence at the time they were written. Health professionals are encouraged to take them fully into account when exercising their clinical judgement. The guidelines do not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patients, in consultation with that patient, and where appropriate and necessary the patient's guardian or carer. It is also the health professional's responsibility to verify the rules and regulations applicable to drugs and devices at the time of prescription.