JAMA

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    Thyroid hormones affect the growth, metabolism, and function of multiple organs in the body. If adaptive mechanisms were not in place during pregnancy, physiological increases in the quantity of circulating thyroid hormone–binding proteins would result in lower concentrations of unbound (free) thyroid hormones and subsequent adverse maternal and fetal consequences. Fortunately, the hypothalamic-pituitary-thyroid axis compensates, […]
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    Psychotic features, such as delusions of guilt or persecution, in major depressive disorder (MDD) attracted little research interest before the observation that patients with psychotic depression responded poorly to tricyclic antidepressants. Subsequent work showed that other depressive symptoms, particularly those of the melancholic subtype, are substantially more severe in this condition than they are in […]
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    The humanized monocolonal antibody eculizumab has been approved for adults with neuromyelitis optica spectrum disorder (NMOSD), a rare autoimmune inflammatory condition of the central nervous system (CNS). The disorder causes recurrent optic neuritis and myelitis, which may lead to permanent vision loss and paralysis.
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    The FDA recently approved bremelanotide for acquired generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. It’s the first “as-needed” treatment for HSDD, a common condition characterized by low libido that causes distress or interpersonal difficulty and isn’t attributed to a coexisting medical or psychiatric condition, relationship problems, or medications.
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    In May 2019 the US Supreme Court sent back to lower courts the question of whether Merck Sharpe & Dohme Corp was liable for atypical fractures from its osteoporosis drug alendronate because it did not identify the adverse effect in the product’s label. This Viewpoint discusses the legal questions of liability raised by the case […]
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    I sprinkle hints, seeds in the withering garden of your brain, hope words will sprout, blossom on your lips. But deep in the gray matter, atrophy spreads like a biblical pestilence. In that un-Eden, hummingbirds dart, like crazed syllables, scatter alphabets like fallen petals amid stems of thought— bare, but pretending to be bright. Colors […]
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    This Viewpoint argues that the near-universal adoption of electronic fetal monitoring (EFM) in labor and delivery units has occurred without evidence that it has reduced adverse neurological events and has contributed to an increase in US cesarean delivery rates, and calls for the education of physicians and the public about EFM’s demonstrated reliability and value.
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    In this narrative medicine essay, a critical care physician works through lessons he learned from his experience with a man with end-stage lung disease going into terminal respiratory failure who consented to intubation only if he had a chance for a lung transplant and considers how to balance patient autonomy with medical paternalism when good […]

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