Assessing, teaching and defining: Issues in obstetrics and gynecology

摘要

The March issue contents are varied and of good quality. There is a meta-analysis from Louise Baandrup and colleagues in Copenhagen, Denmark (pp. 245-255) on the commonly used NSAID drugs and ovarian cancer risks. Research at the Danish Cancer Society has a world-wide reputation and can be considered as authoritative when it comes to both their own epidemiological data-evaluation and reasoned opinions done in a scientifically good fashion. Even if not conclusive, the study is helpful for showing where emphasis must be placed for adding to current knowledge in one of the more difficult fields of our speciality; ovarian cancer management. The discussion is clear on what problems must be overcome when common over-the-counter drugs need to be evaluated in relation to well defined disease entities.Cesarean section is one of the first operations that a trainee in this speciality has to learn and indeed wants to learn fast for the glory of it. Most of us have historically acquired our skills initially on a teacher-apprentice basis where personal preferences of the senior may have weighed more than securely based evidence. Even the now "fashionable" guidelines may differ on what one is recommended to do. Kristine Madsen and colleagues in Copenhagen and Hillerod, Denmark, discuss the training for cesarean section on pp. 256—263. When they suggest international training programs in the last part of their discussion, then such educational strategies are an obvious task to address within our inter-Nordic collaboration efforts. We, the authors of this months Editors Message, know of course exactly how a cesarean section should be done, from start to finish, but who is to say that our individual and probably not quite uniform methods are each the best? One thing is certain: it should not be us. Operative procedures evolve and need scientific scrutiny, not least the common ones. That also applies to bariatric surgery, which Mette Kjser and Lisbeth Nilas, also from Copenhagen, consider in relation to pregnancy on pp. 264-271. That a post-procedure pregnancy can be fatal was recently shown in this journal (1). So far much of the evidence presented on bariatric surgery and pregnancy is in the form of small case series, but in this prospective data-gathering is essential. Most of those having bariatric surgery are women, often of reproductive age and therefore their situation merits specific attention in our over-indulgent and overweight era.