A comparison of various routes and dosages of misoprostol for cervical ripening and the induction of labor.

Objective: The purpose of this study was to compare the efficacy of different routes of misoprostol administration for cervical ripening and the induction of labor.

Study Design: Three hundred thirty women at > or = 32 weeks gestation with a Bishop score < or = 6 and an indication for induction were randomized to 1 of 3 double-blinded groups: (1) 25 microg orally administered misoprostol plus 25 microg vaginally administered misoprostol, (2) orally administered placebo plus 25 microg vaginally administered misoprostol, or (3) 25 microg orally administered misoprostol plus vaginally administered placebo. Doses were repeated every 4 hours until onset of labor or a maximum of 12 doses were given.

Celiac sprue. Diagnosis and diet: keys to recovery.

Celiac sprue is a devastating disease that can have fatal consequences if untreated. Fortunately, if diagnosed correctly and promptly, it can be effectively treated with very satisfactory outcomes. A careful history will often suggest the diagnosis, but definitive diagnosis requires finding the typical lesion on small bowel biopsy and clinical improvement with a gluten-free diet.

Liver test alterations with total parenteral nutrition and nutritional status.

Liver test abnormalities are a well-recognized complication in the parenterally fed population. Numerous etiologies for the development of elevated liver tests have been suggested. However, the etiology and clinical significance remain unclear.