Southern medical journal
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Southern medical journal · Dec 2024
Multicenter Study Comparative StudyComparison of Standard and Extended Dexamethasone Duration on Mortality in Patients with Severe COVID-19.
Current guidelines recommend dexamethasone 6 mg/day for up to 10 days in patients with severe coronavirus disease 2019 (COVID-19) requiring supplemental oxygenation or mechanical ventilation. The practice has significant variation, however, and dexamethasone has been used for >10 days for many patients with severe COVID-19. The aim of this study was to assess the benefits and risks associated with standard versus extended use of dexamethasone in patients with severe COVID-19. ⋯ The results show that extended duration of dexamethasone compared with standard duration is associated with a significant increase in in-hospital mortality in patients with severe COVID-19. These findings need to be confirmed in well-designed and performed randomized controlled trials.
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Hyperphosphatemic familial tumoral calcinosis (HFTC) is a rare, autosomal recessive condition characterized by fibroblast growth factor 23 signaling pathway dysregulation, hyperphosphatemia and ectopic calcifications (which manifest as joint motion limitations), inflammatory bony pain, and disability. Given the rarity and multiorgan involvement of HFTC, a multidisciplinary approach including Dermatology, Ophthalmology, Dentistry, Nephrology, Endocrinology, Rheumatology, and Genetics is necessary for diagnosis and treatment. We present a multidisciplinary diagnostic and treatment approach for a patient with HFTC due to a GALNT3 gene mutation with unique imaging highlighting the extent of calcinosis seen in HFTC. ⋯ Genetic testing revealing a homozygous c.1319C > A variant in GALNT3 predicted to result in a missense mutation p. Ala440Glu. HFTC should be considered for patients presenting with diffuse calcinosis cutis-like features, and a multidisciplinary evaluation should be pursued.
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Southern medical journal · Dec 2024
Patient Interest in Mental Health Screening by Endocrinologists.
Endocrine disorders often coexist with mental health issues. Little is known about patient beliefs regarding endocrinologists' involvement in mental health screening. We studied the beliefs of patients with endocrine disorders regarding endocrinologists' asking about mental health and whether patients perceive that endocrinologists are capable of recognizing mental health concerns. ⋯ Many patients with endocrine disorders want endocrinologists to ask about their mental health. We recommend that endocrinologists consider incorporating mental health screening for depression and anxiety into routine patient care because many patients would welcome this approach.
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Southern medical journal · Dec 2024
Secondary Effects of the COVID-19 Pandemic on Pregnancy Intention.
The coronavirus disease 2019 (COVID-19) pandemic had many downstream effects, including, for some women, altering the wish to become pregnant. This study examines the effects on pregnancy intention and Edinburgh Postnatal Depression Scale (EPDS) score at the initiation of prenatal care in a low-income population during the COVID-19 pandemic. ⋯ There was a significant increase in the number of unplanned pregnancies during the COVID-19 pandemic in a large Medicaid patient population, although the demographics of those having unplanned pregnancies and the average EPDS score did not change significantly.
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Southern medical journal · Dec 2024
Qualitative Exploration of Contraceptive Knowledge in Men and Women.
The level of knowledge about contraceptives overall is low in the United States. This qualitative study adds to the literature that explores gendered differences in contraceptive knowledge. Specifically, we examined knowledge regarding different contraceptive methods, directions on use, mechanism of action, efficacy, and adverse effects. We also looked at men's perspectives on their partner's knowledge. ⋯ A low level of knowledge about contraceptives is associated with increased rates of unintended pregnancy. This study demonstrates a need for improved education about contraception. Given the impact of male opinion in contraceptive use, efforts to increase their knowledge could be important interventions to increase contraceptive uptake.