Article: Comparison of the effect of focused and radial extracorporeal shock waves on spastic equinus in patients with stroke: a randomized controlled trial - European Journal of Physical and Rehabilitation Medicine 2018 August;54(4):518-25 - Minerva Medica - Journals

An association may exist between obstructive sleep apnea (OSA) and depression. However, results regarding this association are inconsistent, and the direction of the association between OSA and depression remains unknown. Therefore, we used the Taiwan National Health Insurance Research Database to investigate the bidirectional association between OSA and depression. A total of 6427 OSA patients and 32,135 age and sex-matched control subjects were enrolled to analyze the risk of depression among patients with OSA, where 27,073 patients with depression and 135,365 control subjects were enrolled to address the risk of OSA among patients with depression. All subjects were followed to identify their outcomes of interest from January 1, 1997 to December 31, 2012. Cox proportional-hazards models, after adjusting for potential confounders, demonstrated that patients with OSA had an increased risk (adjusted hazard ratio 2.48, 95% confidence interval 2.20–2.79) of developing depression, whereas those with depression were associated with an increased risk of future OSA (adjusted hazard ratio 2.30, 95% confidence interval 2.11–2.50). Our results suggested that a strong bidirectional relationship exists between OSA and depression, with each disease influencing the development of the other. Health providers are recommended to ensure the early detection and management of depression among patients with OSA and vice versa.

Background/Objectives: Malnutrition and frailty are independent risk factors of prolonged hospitalization and mortality, respectively. However, the combined association of these conditions with the risk of prolonged hospitalization and mortality in hospitalized elderly patients remains unclear. Our object was to investigate the combined association of malnutrition and frailty on the risk of prolonged hospitalization and mortality in hospitalized elderly patients. Methods: The current study was a retrospective analysis of 470 patients admitted to the geriatric care unit of a tertiary hospital in Taiwan between 01 August 2019 and 31 March 2023. The Mini Nutritional Assessment-short form and Clinical Frailty Scale were used as evaluation tools for nutritional and frailty status, respectively. Patients were divided into four groups based on nutritional and frailty status. The association between these conditions and the risk of prolonged hospitalization and mortality was investigated using multivariate logistic and Cox proportional hazard models and adjusting for potential confounders. Results: Among 470 patients, 144 (31%) exhibited no malnutrition risk or frailty, 146 (31%) exhibited malnutrition risk but no frailty, 46 (10%) exhibited frailty but no malnutrition risk, and 134 (28%) exhibited both malnutrition risk and frailty. Compared to patients with neither condition, those with both conditions had higher risks of prolonged hospitalization (odds ratio 3.23, 95% confidence interval [CI] 1.68–6.12) and mortality (hazard ratio 4.33; 95% CI 2.01–9.34). Conclusion:: The co-occurrence of malnutrition and frailty has significant detrimental impacts on the risk of prolonged hospitalization and mortality in hospitalized older adults. The findings of this study emphasize the importance of early screening and intervention for malnutrition and frailty among hospitalized elderly patients.

Both focused extracorporeal shockwave (f-ESWT) and radial extracorporeal shockwave therapy (r-ESWT) can alleviate symptoms in patients with knee osteoarthritis, but no trials have directly compared f-ESWT with r-ESWT for knee osteoarthritis. This study aimed to compare the effectiveness of f-ESWT and r-ESWT on knee osteoarthritis. Forty-two patients with bilateral knee osteoarthritis were randomly assigned to receive three sessions of either f-ESWT or r-ESWT at 1-week intervals. The patients were evaluated at baseline and at 4 and 8 weeks after the final treatment. The primary outcome was the change in pain intensity, as measured on the visual analog scale (VAS). Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion of the knee joint, and the 6-minute walk test. At the end of 4 weeks, the VAS score was substantially reduced in both groups (f-ESWT, −4.5 ± 2.5 points; r-ESWT, −2.6 ± 2.0 points), with a greater reduction in the f-ESWT group. Both groups showed significant improvement in secondary outcomes; however, the f-ESWT group yielded greater improvement in the VAS score, WOMAC score, and 6-minute walk test. Our results showed that f-ESWT was more effective than r-ESWT in improving pain and physical function in patients with knee osteoarthritis.