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dexamethasone treatment is an established modality in the management of primary nephrotic syndrome and frequently used to induce remission in nephrotic syndrome induced by medications (e.g. cyclosporine) or other causes (e. minimal change disease). recent evidence suggests that dexamethasone causes fluid retention within the glomerular capillary lumen, which induces the plasma leakage that leads to ascites formation. this has been attributed to either a direct toxic effect of dexamethasone or its oxidative metabolite, 6a,9a-dihydrodexamethasone, on the glomerular endothelium or a combination of both effects. high dexamethasone dose and chronic steroid treatment are associated with an increased risk of secondary osteoporosis, which is thought to be due to their antifibrinolytic and prothrombotic effects.

pharmacoepidemiological studies can provide insight to noninterventional studies and can be used to describe the effect of medications in real-world settings, understanding how medications affect the population. however, these types of studies have their own set of concerns with regard to design and conduct. observational studies can use multiple designs to help investigate a particular question; for example, randomized controlled trials, nonrandomized controlled trials, case-controlled studies, and case-cohort studies are all observational designs that have varying strengths and limitations for various study questions. currently, observational studies are considered more cost-effective, efficient, and less resource-intensive than interventional studies, which carry greater risks for participants and are therefore often not feasible. ^{reference 1194} to increase research efficiency, often the choice of design depends on the objective of the study; for example, a prospective observational study design is more appropriate if the objective is to describe the effect of a treatment or risk factor, while a retrospective observational study design can be used if the objective is to develop a predictive model of treatment response and prognosis, or a feasibility study is needed to obtain preliminary data. one of the limitations of these types of studies is the potential for bias, where the outcome of interest (e.g. treatment response) can be influenced by factors other than the intervention of interest (e. treatment response can be associated with, and potentially confounded by, differences in the severity of disease). this can be addressed with proper study design and/or quality assurance protocols, as described in greater detail below.

from the 1990s, it has been shown that anxiety disorders and major depressive disorder are associated with reduced serotonergic and norepinephrinergic tone in the brain and that serotonin and norepinephrine increase the strength of inhibitory synapses in the brain. reference 1642 – 1644 this may be why selective serotonin reuptake inhibitors (ssris) are effective in the treatment of anxiety and depression and why serotonin modulators are effective in the treatment of epilepsy, which may be secondary to dysfunction of the serotonergic system in the brain and may explain the effectiveness of cbd in treating anxiety.
it is hypothesized that location of pain in the neck, shoulder, and arm region in athletes in these time periods was high due to increased training stress. although pectoralis muscle strains are common in endurance athletes, recent studies have suggested that this injury is underdiagnosed, particularly in the olympic year. despite this, it was observed that there was a 50% increase in the number of shoulder injuries reported in endurance athletes, compared to those reported in their non-athletic counterparts.180
nasal septum deviation occurs when the septum deviates from the vertical nasal plane, resulting in a non-coplanar relationship between the turbinates and the nasal septum. while there are numerous other structures that can be affected such as the inferior turbinate, middle turbinate, the posterior maxillary wall, medial canthal ligament, and the infraorbital nerve, the septum is the most prominent of these structures.10 a systematic review by gholamirad et al 168 was conducted to assess the efficacy of endoscopic septal deviation correction compared to the least invasive alternative in the treatment of nasal septum deviation. the authors found that there was a statistically significant higher prevalence of inferior turbinate hypertrophy (26.9%) and concha hypertrophy (55.6%) in the endoscopic group compared to the control group (9.7% and 21.9%, respectively). while the overall complication rate was comparable between the two groups, the study reported a significantly greater recurrent septal deviation in the control group. this systematic review included 11 publications representing 710 adult patients. the authors concluded that endoscopic correction of nasal septal deviation in adults is associated with a higher prevalence of inferior turbinate hypertrophy and concha hypertrophy, compared to the least invasive alternative. given the size of the included studies and a lack of strict inclusion criteria, the authors suggest that there is limited evidence to support the use of endoscopic septal correction as a primary approach to nasal septal deviation in adults.
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