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To examine whether oral administration of paracetamol as a first-line agent had a greater effect on the closure of a patent ductus arteriosus than the intravenous route.We performed a retrospective study of preterm infants (37 weeks of gestation) between 2012 and 2020 treated with oral or intravenous paracetamol as the first line for patent ductus arteriosus (PDA) constriction and compared rates of ductal closure, course duration, cumulative dose, PDA characteristics, and serum levels.Over the study period, 80 preterm infants received paracetamol, of which 50 received paracetamol as first-line treatment to augment constriction of the PDA. Closure rate was higher in the oral group (n = 15/19, 79%) compared to the intravenous group (n = 8/20, 40%, p 0.01), and remained significant after adjusting for gestational age, length of treatment, and postnatal age (OR 0.14, 95% CI 0.03-0.67, p = 0.014, RR 0.51, 95% CI 0.28-0.91). Eleven preterm infants received a combination of both oral and intravenous paracetamol with a closure rate of 45% (n = 5).Oral administration of paracetamol as a first-line agent is more efficacious to constrict the PDA than the intravenous route, irrespective of gestational age or course duration.Our retrospective study comparing the use of oral versus intravenous paracetamol as the first line for patent ductus arteriosus (PDA) constriction in preterm infants demonstrates that oral administration of paracetamol is more efficacious to constrict the PDA than the intravenous route, irrespective of gestational age or course duration. To our knowledge, this is the first published study (prospective or retrospective) to compare the efficacy of oral versus intravenous paracetamol as a first-line treatment for PDA closure in preterm infants. Our finding may improve the rate of PDA closure when paracetamol is used as a first-line agent.

Obstructive sleep apnea (OSA) is associated with hypertension. In the current study we sought to determine whether the evening-morning differences in blood pressure (BP) would correlate with the severity of OSA and whether there are gender-related differences.A total of 2009 consecutive patients referred to sleep examination because of suspected sleep apnea were retrospectively included. The patients comprised 1566 men, of whom 870 were nonhypertensive (non-HT) and 696 hypertensive (HT) and 443 women, of whom 258 were non-HT and 185 HT. Four BP measurements, two in the evening and two in the morning, were taken. The relationship between evening-morning differences in BP and the number of apneas/hypopneas divided by hours of sleep (AHI) were analyzed separately for HT and non-HT men and women.In men, increase in AHI was associated with increase in morning BP, and the evening-morning difference for both systolic and diastolic BP became negative. These trends were found to be significant by linear regression analyses both for HT (for systolic BP, r = 0.75, P.05, for diastolic BP r = 0.96, P.05) and non-HT patients (for systolic BP r = 0.93, P.05, for diastolic BP r = 0.94, P.05). In women (unlike in men), increasing AHI was not associated with a linear increase in the evening-morning BP differences. None of the regression lines fitted to the data was significant.Our results demonstrate that the evening to morning difference in BP in men with OSA is linearly related to the severity of OSA, both in patients with HT and in those with non-HT. These results may have practical relevance in screening for patients with OSA and may have prognostic clinical value in predicting future cardiovascular events.