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British Medical Journal (The BMJ)
The question of whether, when, and how children and adolescents with gender dysphoria should be treated medically or surgically is contentious. Gender dysphoria in the United States is being treated with “gender affirming care,” which may include gonadotrophin releasing hormone analogues (GnRHa) to suppress puberty, oestrogen or testosterone to promote secondary sex characteristics, and surgical removal or augmentation of breasts, genitals, or other physical features. At the same time, several European countries have issued guidelines limiting medical intervention in minors and emphasizing psychological care. There is little doubt in the medical community that children in distress require care, but there are concerns about the rapid widespread adoption of interventions and calls for rigorous scientific review from all corners.
Endocrinology, Diabetes, Metabolism March 7th 2023
The New England Journal of Medicine
In the ER, the patient was disoriented and appeared pale and diaphoretic. He initially complained of dizziness, shortness of breath, ringing in the ears, and feeling “weird.” Temperature and oxygen saturation were normal. BP was 182/112, and blood glucose was 152. Initial labs and studies showed no obvious cause for the patient’s problem. Follow Dr. Antonio Granfone through the differential and the ultimate discovery and correction of the cause.
Family Medicine/General Practice February 7th 2023
Cleveland Clinic Journal of Medicine
The authors speculate that pharmacogenomic testing can identify patients at higher risk for adverse events related to drug-drug and drug-gene interactions based on the 29-year-old man’s prescription list and gene testing results. Potential drug-drug interactions should also be investigated, and patients should be appropriately monitored for adverse reactions. Before performing pharmacogenomic testing, consider the severity of potential reactions, cost, and the possibility of using an alternative regimen that avoids the interaction of concern entirely. As more is learned about pharmacogenomics and the potential personalization of therapeutic regimens, clinical considerations that warrant testing should be evaluated on a regular basis to facilitate both resource stewardship and optimal patient care.
Clinical Pharmacology January 30th 2023
Psychiatrist.com
In comparing PTSD to PTSD plus sexual abuse, minors with PTSD following sexual abuse are more likely to suffer MDD, substance use disorder, and suicidal behavior.
Internal Medicine January 24th 2023
Addiction Professional
The US Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) issued the 2021 National Survey on Drug Use and Health (NSDUH) this week. The NDSUH offers a window into Americans’ experiences with mental health disorders, substance use, and their pursuit of treatment during the second year of the COVID epidemic through chosen estimates by race, ethnicity, and age group. Enough said—the outcomes aren’t appealing.
Family Medicine/General Practice January 18th 2023
The American Journal of Psychiatry
The American Journal of Psychiatry presents this review of the most compelling articles that were covered in 2022: The Molecular and Cellular Alterations That Underpin Psychiatric Illnesses Shared and Distinct Neurobiological Mechanisms of PTSD Cognitive Deficits in Long-Term Cannabis Users Longitudinal Outcomes of Duration of Untreated Psychosis Accelerating TMS in the Treatment of Depression Infant Brain Development, Fragile X Syndrome, and Autism Spectrum Disorder Combining Computational Modeling and Postmortem Human Brain Studies to Uncover Synaptic Variability Contributions to Cortical Gamma Oscillation From the AJP Residents’ Journal: Identity and Stigma
Psychiatry January 10th 2023