misoprostol and Sleep-Apnea-Syndromes

Familiar measures of association for 2 x 2 tables are the odds ratio, the risk ratio and the risk difference. Analagous measures of outcome-exposure association are desirable when there are several degrees of severity of both exposure and disease outcome. One such measure (alpha), which we label the general odds ratio (OR(G)), was proposed by Agresti. Convenient methods are given for calculation of both standard error and 95 per cent confidence intervals for OR(G). Other approaches to generalizing the odds ratio entail fitting statistical models which might not fit the data, and cannot handle some zero frequencies. We propose a generalization of the risk ratio (RR(G)) following the statistical approaches of Agresti, Goodman and Kruskal. A method of calculating the standard error and 95 per cent confidence interval for RR(G) is provided. A known statistic, Somers' d, fulfils the characteristics necessary for a generalized risk difference (RD(G)). These measures have straightforward interpretations, are easily computed, are at least as precise as other methods and do not require fitting statistical models to the data. We also examine the pooling of such measures as in, for example, meta-analysis.

Topics: Anti-Ulcer Agents; Confidence Intervals; Epidemiologic Methods; Humans; Misoprostol; Odds Ratio; Polysomnography; Risk; Sleep Apnea Syndromes

We report a case showing the association of Moebius syndrome, the use of misoprostol during pregnancy and the development of central congenital alveolar hypoventilation. Pathophysiological aspects of these three diseases are discussed and also the unfavorable prognosis of this association.

Topics: Abnormalities, Multiple; Abortifacient Agents, Nonsteroidal; Humans; Infant; Male; Misoprostol; Respiration, Artificial; Sleep Apnea Syndromes; Syndrome

Attempts to get good results from fewer health care dollars received considerable attention during the recent annual meeting of the Royal College of Physicians and Surgeons of Canada. Pam Harrison provides an overview of some research findings presented during the meeting, held in Montreal.

Topics: Analgesics, Opioid; Canada; Clinical Medicine; Computers; Hemorrhoids; Humans; Methadone; Misoprostol; Oxytocics; Polysomnography; Sex Offenses; Sleep Apnea Syndromes; Societies, Medical; Vitamin D