METHODS: This non-blinded, randomized clinical trial included 228 pregnant women at term with obstetric or medical indications for induction of labour. Women either took 50 µg misoprostol orally (two 25 µg tablets) or had one 25 µg tablet of misoprostol inserted in the posterior vaginal fornix. In each group, misoprostol administration was repeated every four hours in the same dose until regular uterine contractions were established or to a maximum of five doses. Time to delivery and outcome data for each group were compared.
RESULTS: Of the 228 women, eight (3.5%) were excluded from the analysis as they withdrew their consent after randomization. Mean induction-to-delivery interval was similar in both groups (21.22 hours in the oral group vs. 20.15 hours in the vaginal group; P = 0.58). There was no significant difference between the groups with respect to the number of women who delivered within 24 hours or who required oxytocin augmentation of labour, the mode of delivery, and neonatal outcomes (P > 0.05). Uterine hyperstimulation occurred in two women who received misoprostol vaginally, but not in any of the women in the oral misoprostol group.
CONCLUSION: Oral misoprostol in a dose of 50 µg every four hours, to a maximum of five doses, has the potential to induce labour as safely and effectively as 25 µg misoprostol administered vaginally every four hours.
MATERIAL AND METHODS: In this cross-sectional study, 102 patients with suspected OSA underwent standard polysomnography. All patients with an apnea-hypopnea index (AHI) of ≥5 with symptoms were diagnosed as having OSA. A fasting blood sample was collected from all patients. Blood levels of triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) were measured. The relationship between the AHI and lipid profiles was analyzed, and linear regression analysis was performed to evaluate the effect of dyslipidemia on OSA.
RESULTS: The patients with OSA had a significantly higher TG level and a significantly lower HDL level than did those without OSA. The lipid abnormalities increased with OSA severity. The mean serum TG level was higher in the severe OSA group (175±46.5 vs. 153±42.45, mg/dl P = 0.048), and the mean serum HDL level was lower in the severe OSA group (38.43 ± 5.19 vs. 45.73 ± 4.98, mg/dl P = 0.004). Serum TG, cholesterol, and LDL levels were correlated with a BMI of <30 and a BMI of >30 in the OSA group. Linear regression analysis indicated that only age (β = 0.301, P = 0.000), BMI (β = 0.455, P = 0.000), serum HDL level (β = -0.297, P = 0.012), and serum LDL level (β = 0.429, P = 0.001) were the independent predictors of OSA.
CONCLUSION: OSA and obesity are potential risk factors for dyslipidemia. The diagnosis of hyperlipidemia was linked to OSA, and the association was more significant with OSA severity. Hyperlipidemia was well recognized in patients with OSA. LDL and HDL are the independent predictors of OSA.
METHODS: The systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Searches were performed in multiple databases, and studies meeting predefined criteria were included. Data extraction, risk of bias assessment, and statistical analysis were carried out to compare treatment modalities. The analysis was categorized into short-term (within six weeks), medium-term (six weeks up to six months), and long-term (one year) follow-up.
RESULTS: The analysis included 14 randomized controlled trials encompassing various treatment modalities for De Quervain tenosynovitis. In the short-term, extracorporeal shockwave therapy demonstrated statistically significant improvement in visual analog scale pain scores compared with placebo. Extracorporeal shockwave therapy also ranked highest in the treatment options based on its treatment effects. Corticosteroid injections (CSIs) combined with casting and laser therapy with orthosis showed favorable outcomes. Corticosteroid injection alone, platelet-rich plasma injections alone, acupuncture, and orthosis alone did not significantly differ from placebo in visual analog scale pain score. In the medium-term, extracorporeal shockwave therapy remained the top-ranking option for visual analog scale pain score, followed by CSI with casting. In the long-term (one year), CSI alone and platelet-rich plasma injections demonstrated sustained pain relief. Combining CSI with orthosis also appeared promising when compared with CSI alone.
CONCLUSIONS: Corticosteroid injection with a short duration of immobilization remains the primary and effective treatment for De Quervain tenosynovitis. Extracorporeal shockwave therapy can be considered a secondary option. Alternative treatment modalities, such as isolated therapeutic injection, should be approached with caution because they did not show substantial benefits over placebo.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.
METHODS: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action.
RESULTS: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied.
DISCUSSION: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.