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2 Minute Medicine Rewind March 23, 2026
1. Most women with pregnancy-related pelvic girdle pain regained meaningful function by 4 months after delivery, and this improvement was largely maintained at 3 years.
2. A greater number of positive pelvic provocation tests at 4 months after delivery predicted persistent pelvic girdle pain at 3 years and may help identify patients who need closer follow-up.
Evidence Rating Level: 1 (Excellent)
Pelvic girdle pain (PGP) is common in pregnancy and can limit mobility, work capacity, and participation in daily activities. Because some women continue to have symptoms long after delivery, this study examined longer-term functional recovery after physiotherapy for pregnancy-related PGP. The authors performed a 3-year follow-up of a randomized controlled trial comparing acupuncture with transcutaneous electrical nerve stimulation (TENS) in 113 pregnant women with clinically verified PGP in Sweden. Women were followed at baseline, after 5 weeks of treatment, at 4 months postpartum, and again at 3 years postpartum. The primary outcome was the Patient-Specific Functional Scale (PSFS), a person-centred measure based on activities selected by each participant; secondary outcomes included self-reported PGP, Pelvic Girdle Questionnaire scores, pain-related concern, and the prognostic value of pelvic provocation tests. At 3 years postpartum, the mean PSFS score was 8.64, and 45.6% of participants reported complete return to baseline activities. Functional scores improved significantly over time, with no significant difference between acupuncture and TENS. Higher pain-related concern and higher Pelvic Girdle Questionnaire scores were associated with worse function. At 4 months postpartum, each additional positive pelvic provocation test nearly tripled the odds of self-reported PGP at 3 years (OR 2.98, 95% CI 1.26–7.05). Overall, most women recovered function by 4 months and maintained it at 3 years, but persistent positive provocation tests may help identify patients who need closer postpartum follow-up.
1. Sitagliptin demonstrated the most prominent malignancy-related safety signal among the dipeptidyl peptidase 4 inhibitors studied.
Evidence Rating Level: 2 (Good)
Dipeptidyl peptidase 4 inhibitors are widely used for type 2 diabetes because they have a low risk of severe hypoglycemia and are weight neutral, but their relationship with malignancy remains uncertain. This study used the FDA Adverse Event Reporting System from January 2019 through December 2024 to assess malignancy-related adverse event signals among patients with type 2 diabetes receiving sitagliptin, saxagliptin, linagliptin, alogliptin, or vildagliptin. The authors performed descriptive analyses, disproportionality testing using reporting odds ratios and information components, and adjusted logistic regression to account for age, sex, and selected concomitant medications. They identified 3,764 malignancy-related reports. Sitagliptin showed the strongest and broadest signal across both standardized query groupings and preferred terms. After adjustment, positive associations persisted for sitagliptin, vildagliptin, and linagliptin, whereas saxagliptin was not statistically significant, and alogliptin showed an inverse association. Most reported events occurred in older adults, with median ages above 70 years in most groups. In drugs with larger sample sizes, the median time to event onset was approximately 13 to 15 months. The authors conclude that these findings represent pharmacovigilance signals rather than proof of causation, but they support closer surveillance and the need for large prospective studies to determine whether these associations reflect true cancer risk.
1. Maternal prothrombin time measured at delivery was the only independent maternal laboratory predictor of neonatal sepsis in this cohort.
2. A maternal prothrombin time cutoff of 10.25 seconds showed high sensitivity and moderate specificity, suggesting possible utility as a screening adjunct at birth.
Evidence Rating Level: 2 (Good)
This retrospective single-center case–control study evaluated whether maternal hemostatic and inflammatory markers measured at delivery could help predict neonatal sepsis. The authors included 176 newborns delivered between April 2022 and April 2025, of whom 37 developed neonatal sepsis within the first 72 hours of life, and 139 served as healthy controls. Maternal laboratory values assessed at delivery included white blood cell count, neutrophil-to-lymphocyte ratio, platelet count, prothrombin time, activated partial thromboplastin time, international normalized ratio, and several derived inflammatory indices. Compared with controls, mothers of neonates with sepsis had significantly higher prothrombin time, activated partial thromboplastin time, international normalized ratio, and systemic inflammation response index. However, on multivariable logistic regression, maternal prothrombin time was the only independent predictor of neonatal sepsis, with an odds ratio of 1.79. Receiver operating characteristic analysis showed that prothrombin time had the best diagnostic performance, with an area under the curve of 0.909. A cutoff of 10.25 seconds yielded a sensitivity of 89.2% and a specificity of 68.3%. The authors conclude that maternal prothrombin time is a readily available, low-cost marker with strong potential to support delivery-time neonatal sepsis risk stratification, although larger multicenter studies are needed for validation.
1. Maintaining systolic blood pressure in a lower, stable range during the first 24 hours after intracerebral hemorrhage was associated with the best 90-day functional outcomes.
2. Patients with persistently severe hypertension had the highest risk of poor outcome, supporting a tailored rather than uniformly aggressive blood pressure strategy.
Evidence Rating Level: 2 (Good)
This pooled individual patient-level post hoc analysis evaluated whether early systolic blood pressure patterns after acute intracerebral hemorrhage were associated with 90-day outcomes. The investigators combined data from the four INTERACT trials and ATACH-II, including 11,269 patients with at least one post-randomization blood pressure measurement. Using latent class analysis, they identified six systolic blood pressure trajectories over the first 24 hours: low, moderate-to-low, moderate, high, high-to-moderate, and high-to-low. The primary outcome was a poor functional outcome at 90 days, defined as a modified Rankin Scale score of 3 to 6. In the INTERACT cohorts, patients in the low trajectory group, with blood pressure falling from a mean baseline of about 149 mm Hg to 120 to 130 mm Hg over 24 hours, had the best outcomes. Compared with this group, the odds of poor functional outcome increased across the higher trajectory groups, with the worst outcomes seen in the high-to-moderate group. A similar direction of effect was seen in ATACH-II, although this was not statistically significant. Mortality and serious cardiac or renal adverse events did not differ significantly across trajectories. Overall, the study suggests that early, sustained, and well-controlled systolic blood pressure reduction is associated with better functional recovery after intracerebral hemorrhage, whereas persistently severe hypertension identifies a high-risk subgroup that may need more individualized treatment.
1. For popliteal plexus block after total knee arthroplasty, 10 mL of local anesthetic appears sufficient, as 20 mL offers no added benefit in pain control or early functional recovery.
Evidence Rating Level: 1 (Excellent)
In this single-center, blinded randomized controlled trial, investigators evaluated whether a larger volume of local anesthetic improves outcomes for popliteal plexus block after primary unilateral total knee arthroplasty. A total of 120 adults undergoing surgery under spinal anesthesia were randomized to receive either 10 mL or 20 mL of bupivacaine for the popliteal plexus block, in addition to a standardized multimodal analgesic regimen that included a femoral triangle block. The primary outcome was 24-hour postoperative opioid consumption, while secondary outcomes included opioid-free analgesia, pain scores, early functional recovery, motor impairment, ambulation with crutches, and Quality of Recovery-15 scores. The study found no statistically significant or clinically meaningful differences between groups in 24-hour opioid use, likelihood of remaining opioid-free, pain at rest or with walking, functional mobility, motor function, or patient-reported recovery. These findings suggest that increasing the block volume from 10 mL to 20 mL does not improve analgesia or early recovery after total knee arthroplasty.
Image: PD
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