Sexual health education has significant implications on the physical and mental well-being of adolescents, yet several barriers impede the delivery of a quality curriculum. This article explores the challenges and importance of comprehensive sexual education. Through the experiences of adolescents like “Maya” (pseudonym), we discuss the need for safe spaces, inclusive curricula, and supportive networks to address gaps in sexual health education. The article also examines the current landscape of sexual education across the United States, emphasizing the role of advocacy and community-driven initiatives in promoting standardized, inclusive, and comprehensive programs. It concludes with actionable steps individuals can take at the local, national, and legislative level to support and advance comprehensive sexual health education.
{"title":"Fostering open dialogue: Creating safe spaces for adolescents to discuss sexual health","authors":"Jennifer H. Lee, Yunna Gu","doi":"10.52504/001c.121577","DOIUrl":"https://doi.org/10.52504/001c.121577","url":null,"abstract":"Sexual health education has significant implications on the physical and mental well-being of adolescents, yet several barriers impede the delivery of a quality curriculum. This article explores the challenges and importance of comprehensive sexual education. Through the experiences of adolescents like “Maya” (pseudonym), we discuss the need for safe spaces, inclusive curricula, and supportive networks to address gaps in sexual health education. The article also examines the current landscape of sexual education across the United States, emphasizing the role of advocacy and community-driven initiatives in promoting standardized, inclusive, and comprehensive programs. It concludes with actionable steps individuals can take at the local, national, and legislative level to support and advance comprehensive sexual health education.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"20 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clifford A. Kim, J. M. H. Aguilar, Laura Hidalgo, Emily Katz
As a type of assisted reproductive technology (ART), in vitro fertilization (IVF) has been available for more than 4 decades, with the first successful birth using conventional IVF (C-IVF) occurring in 1978. C-IVF has become increasingly available and accessible over the years and is currently a widely used alternative treatment option for prospective parents experiencing infertility. In addition, science and technological advancements have given rise to other IVF techniques that allow families to choose the ART that best fits their personal and unique needs. Among the other IVF techniques, natural cycle IVF, mild stimulation IVF, and in vitro maturation are notable for being less disruptive to the female body and are referred to as minimally disruptive ARTs (MDARTs). However, deciding which MDART to choose is a complex and daunting task that precedes an already emotionally, financially, and physically taxing process. This review explores these modern ART strategies, including protocols, advantages, and limitations, as well as provides the MDART decision matrix that translates these considerations into a practical decision-making guide for patients seeking IVF.
{"title":"Review of minimally disruptive in vitro fertilization (IVF) approaches as a strategy for assisted human conception","authors":"Clifford A. Kim, J. M. H. Aguilar, Laura Hidalgo, Emily Katz","doi":"10.52504/001c.117697","DOIUrl":"https://doi.org/10.52504/001c.117697","url":null,"abstract":"As a type of assisted reproductive technology (ART), in vitro fertilization (IVF) has been available for more than 4 decades, with the first successful birth using conventional IVF (C-IVF) occurring in 1978. C-IVF has become increasingly available and accessible over the years and is currently a widely used alternative treatment option for prospective parents experiencing infertility. In addition, science and technological advancements have given rise to other IVF techniques that allow families to choose the ART that best fits their personal and unique needs. Among the other IVF techniques, natural cycle IVF, mild stimulation IVF, and in vitro maturation are notable for being less disruptive to the female body and are referred to as minimally disruptive ARTs (MDARTs). However, deciding which MDART to choose is a complex and daunting task that precedes an already emotionally, financially, and physically taxing process. This review explores these modern ART strategies, including protocols, advantages, and limitations, as well as provides the MDART decision matrix that translates these considerations into a practical decision-making guide for patients seeking IVF.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"311 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Computer-mediated communication has a multifaceted effect on health care satisfaction. This relationship has not been studied among middle-aged men living with HIV. The current study extracted data from the Multicenter AIDS Cohort Study (MACS) to examine the association between computer-mediated communication and health care satisfaction. The MACS is a prospective study of more than 7000 sexual minority men living with and without HIV. The Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men was a substudy of the MACS. Current analyses use cross-sectional data on 1063 participants from this substudy with survey data between October 2017 and March 2018. Patients ranked their top 3 methods for communicating with someone they trust. Latent class analysis was used to create classes of health care satisfaction. Multinomial logistic regression was used to estimate the effect of primary communication method on health care satisfaction class membership. Covariates included age, HIV status, race and ethnicity, education, and comorbidities. Interaction was tested between HIV serostatus and primary communication method. Regardless of HIV status, participants preferred in-person communication over computer-mediated communication and were satisfied with the health care they received. Participants who preferred computer-mediated communication were more likely to have low health care satisfaction. There was a statistically nonsignificant association of HIV status with preferred communication method and health care satisfaction. We postulated that in-person communication promoted high health care satisfaction due to the process of rewarding face-to-face communication through the exchange of both verbal and nonverbal cues. However, patients’ preference of communication mode may be moderated by the context of consultation.
{"title":"Computer-mediated Communication and Healthcare Satisfaction among Middle-aged Men Living with or without HIV","authors":"Shiyang Xu, Deanna Ware, Michael Plankey","doi":"10.52504/001c.118699","DOIUrl":"https://doi.org/10.52504/001c.118699","url":null,"abstract":"Computer-mediated communication has a multifaceted effect on health care satisfaction. This relationship has not been studied among middle-aged men living with HIV. The current study extracted data from the Multicenter AIDS Cohort Study (MACS) to examine the association between computer-mediated communication and health care satisfaction. The MACS is a prospective study of more than 7000 sexual minority men living with and without HIV. The Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men was a substudy of the MACS. Current analyses use cross-sectional data on 1063 participants from this substudy with survey data between October 2017 and March 2018. Patients ranked their top 3 methods for communicating with someone they trust. Latent class analysis was used to create classes of health care satisfaction. Multinomial logistic regression was used to estimate the effect of primary communication method on health care satisfaction class membership. Covariates included age, HIV status, race and ethnicity, education, and comorbidities. Interaction was tested between HIV serostatus and primary communication method. Regardless of HIV status, participants preferred in-person communication over computer-mediated communication and were satisfied with the health care they received. Participants who preferred computer-mediated communication were more likely to have low health care satisfaction. There was a statistically nonsignificant association of HIV status with preferred communication method and health care satisfaction. We postulated that in-person communication promoted high health care satisfaction due to the process of rewarding face-to-face communication through the exchange of both verbal and nonverbal cues. However, patients’ preference of communication mode may be moderated by the context of consultation.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141267242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander Sukharev, Tami Alade, Veranca Shah, Sophia Dahmani
Finasteride (marketed as Propecia) is a potent 5α-reductase inhibitor used as first-line treatment for male pattern baldness. Despite finasteride’s efficacy in promoting hair growth, there is concern about its impact on male reproduction because finasteride use has been linked to reduced libido, erectile dysfunction, and potential spermatogenic failure. The drug has also been documented to induce nonreproductive adverse effects such as depression. Current research suggests that finasteride’s alteration of neurosteroid hormone levels may be contributing to these adverse effects. This article used evidence-based research to evaluate finasteride’s short- and long-term effects on male reproductive health. In summary, there appears to be contradictory evidence within the literature with data both in support and in opposition of finasteride’s adverse effects. There does, however, seem to be consensus on the incidence of these cases being quite low within both research and clinical settings.
{"title":"Does Propecia Cause More Harms than Good: Assessing Reproductive and Non-Reproductive Effects of Finasteride on Male Health","authors":"Alexander Sukharev, Tami Alade, Veranca Shah, Sophia Dahmani","doi":"10.52504/001c.117947","DOIUrl":"https://doi.org/10.52504/001c.117947","url":null,"abstract":"Finasteride (marketed as Propecia) is a potent 5α-reductase inhibitor used as first-line treatment for male pattern baldness. Despite finasteride’s efficacy in promoting hair growth, there is concern about its impact on male reproduction because finasteride use has been linked to reduced libido, erectile dysfunction, and potential spermatogenic failure. The drug has also been documented to induce nonreproductive adverse effects such as depression. Current research suggests that finasteride’s alteration of neurosteroid hormone levels may be contributing to these adverse effects. This article used evidence-based research to evaluate finasteride’s short- and long-term effects on male reproductive health. In summary, there appears to be contradictory evidence within the literature with data both in support and in opposition of finasteride’s adverse effects. There does, however, seem to be consensus on the incidence of these cases being quite low within both research and clinical settings.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"21 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Judicial Action Threatens Skin Cancer Prevention for 80 Million Americans","authors":"Kareena S. Garg, Eric L. Wan, Michael Cardis","doi":"10.52504/001c.93910","DOIUrl":"https://doi.org/10.52504/001c.93910","url":null,"abstract":"","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"58 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jasmine Gulati, Mason Zhu, Jacob Gilbreth, Soobin Wang
Despite the use of pharmacological therapies, the morbidity and mortality of cardiac diseases remain high. This paper aims to review multiple promising therapies and highlight the innovative role that stem cells can play. Stem cells have been identified as a potential therapeutic alternative to current mainstay medical and surgical interventions for cardiac pathologies, as these cells possess multipotent capabilities that could aid in cardiac regeneration and remodeling without the detriment of scar tissue. Numerous studies have explored the preliminary safety and efficacy of stem cell treatments in cardiac diseases, specifically ischemic heart disease (IHD), congenital heart disease (CHD), and dilated cardiomyopathy (DCM). IHD studies utilized intracoronary and intramyocardial delivery of various stem cell types and found efficacy with intramyocardial delivery of autologous mesenchymal stem cells injected into infarcted cardiac tissue. Similarly, CHD studies utilized intracoronary delivery of cardiosphere-derived cells in conjunction with the well-established Norwood Procedure and found benefits in cardiac function and somatic cell growth. DCM studies in murine models and subsequent clinical trials showed that transplantation with CD34+ stem cells, a cell type marked by muscle satellite cells, improved cardiac function and increased exercise capacity when delivered via intracoronary or transendocardial transplantation methods. While these cumulative results show promise, longer follow-ups and larger sample sizes are needed to validate the efficacy of this therapeutic approach for cardiac diseases in the long term. Stem cells, when combined with existing therapies, have the potential to mitigate the grave morbidity and mortality associated with cardiac pathologies.
{"title":"The Use of Stem Cells in Cardiac Pathologies: A Review","authors":"Jasmine Gulati, Mason Zhu, Jacob Gilbreth, Soobin Wang","doi":"10.52504/001c.94024","DOIUrl":"https://doi.org/10.52504/001c.94024","url":null,"abstract":"Despite the use of pharmacological therapies, the morbidity and mortality of cardiac diseases remain high. This paper aims to review multiple promising therapies and highlight the innovative role that stem cells can play. Stem cells have been identified as a potential therapeutic alternative to current mainstay medical and surgical interventions for cardiac pathologies, as these cells possess multipotent capabilities that could aid in cardiac regeneration and remodeling without the detriment of scar tissue. Numerous studies have explored the preliminary safety and efficacy of stem cell treatments in cardiac diseases, specifically ischemic heart disease (IHD), congenital heart disease (CHD), and dilated cardiomyopathy (DCM). IHD studies utilized intracoronary and intramyocardial delivery of various stem cell types and found efficacy with intramyocardial delivery of autologous mesenchymal stem cells injected into infarcted cardiac tissue. Similarly, CHD studies utilized intracoronary delivery of cardiosphere-derived cells in conjunction with the well-established Norwood Procedure and found benefits in cardiac function and somatic cell growth. DCM studies in murine models and subsequent clinical trials showed that transplantation with CD34+ stem cells, a cell type marked by muscle satellite cells, improved cardiac function and increased exercise capacity when delivered via intracoronary or transendocardial transplantation methods. While these cumulative results show promise, longer follow-ups and larger sample sizes are needed to validate the efficacy of this therapeutic approach for cardiac diseases in the long term. Stem cells, when combined with existing therapies, have the potential to mitigate the grave morbidity and mortality associated with cardiac pathologies.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"75 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140229875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wunderlich syndrome is a spontaneous, non-traumatic, sub-capsular perinephric hematoma described by a triad of acute flank pain, the presence of flank mass, and hypovolemic shock. This acute syndrome is mostly caused by renal malignancies, particularly renal angiomyolipoma and renal cell carcinoma. Computed tomography (CT) scan is the preferred diagnostic modality for Wunderlich syndrome and its treatment depends on the cause. Herein, we present a 41- year-old male admitted with flank pain, who was subsequently found to have thrombocytosis, hematuria, and hypotension. A computed tomographic scan revealed a kidney mass and hematoma, which was removed. Biopsy of the mass revealed undifferentiated renal cell carcinoma and the mass caused malignant pleural effusion. This case report demonstrates increasing platelet counts, which raised concern for advanced malignancy and the triad of features may not always be present. It also highlights the etiology, clinical manifestation, and management of this syndrome.
{"title":"Undifferentiated Renal Cell Carcinoma Presenting As Wunderlich Syndrome: A Case Report","authors":"Saurab Karki, Mahyar Toofantabrizi","doi":"10.52504/001c.91096","DOIUrl":"https://doi.org/10.52504/001c.91096","url":null,"abstract":"Wunderlich syndrome is a spontaneous, non-traumatic, sub-capsular perinephric hematoma described by a triad of acute flank pain, the presence of flank mass, and hypovolemic shock. This acute syndrome is mostly caused by renal malignancies, particularly renal angiomyolipoma and renal cell carcinoma. Computed tomography (CT) scan is the preferred diagnostic modality for Wunderlich syndrome and its treatment depends on the cause. Herein, we present a 41- year-old male admitted with flank pain, who was subsequently found to have thrombocytosis, hematuria, and hypotension. A computed tomographic scan revealed a kidney mass and hematoma, which was removed. Biopsy of the mass revealed undifferentiated renal cell carcinoma and the mass caused malignant pleural effusion. This case report demonstrates increasing platelet counts, which raised concern for advanced malignancy and the triad of features may not always be present. It also highlights the etiology, clinical manifestation, and management of this syndrome.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Social determinants of health have immense influence on the overall health outcomes of individuals. Homelessness, when set within the context of the socioecological model, includes relevant individual/personal factors like such as substance use and depression, social/interpersonal factors such as stigma, and structural factors including subsistence needs and access to health care or utilization of health care. These 3 types of factors influence adherence levels to antiretroviral therapy. To identify associations between homelessness and antiretroviral therapy adherence and relationships between other modifying variables associated with housing status and treatment adherence. A literature search was conducted using PubMed from 2000 to 2023. A total of 10 articles from this search were identified as appropriate for inclusion, with an additional 2 articles added from parsing references in already approved articles. The literature supports a negative association between homelessness and adherence to antiretroviral therapy. Additionally, a variety of factors were found to modify adherence levels in people living with HIV experiencing homelessness, with increased access and reduced barriers to health care mitigating the effect of homelessness on adherence, while unfulfilled subsistence needs reduce adherence levels. An identified intervention in the literature was supportive housing, which entails the provision of housing to those experiencing homelessness to improve their HIV-related health outcomes. Among urban populations in the United States, homelessness and other relevant factors had a significant association with reduced adherence levels to antiretroviral therapy in people living with HIV.
{"title":"Antiretroviral Therapy Adherence Among People Living With HIV While Experiencing Homelessness","authors":"Grace Graham, Michael W. Plankey","doi":"10.52504/001c.90758","DOIUrl":"https://doi.org/10.52504/001c.90758","url":null,"abstract":"Social determinants of health have immense influence on the overall health outcomes of individuals. Homelessness, when set within the context of the socioecological model, includes relevant individual/personal factors like such as substance use and depression, social/interpersonal factors such as stigma, and structural factors including subsistence needs and access to health care or utilization of health care. These 3 types of factors influence adherence levels to antiretroviral therapy. To identify associations between homelessness and antiretroviral therapy adherence and relationships between other modifying variables associated with housing status and treatment adherence. A literature search was conducted using PubMed from 2000 to 2023. A total of 10 articles from this search were identified as appropriate for inclusion, with an additional 2 articles added from parsing references in already approved articles. The literature supports a negative association between homelessness and adherence to antiretroviral therapy. Additionally, a variety of factors were found to modify adherence levels in people living with HIV experiencing homelessness, with increased access and reduced barriers to health care mitigating the effect of homelessness on adherence, while unfulfilled subsistence needs reduce adherence levels. An identified intervention in the literature was supportive housing, which entails the provision of housing to those experiencing homelessness to improve their HIV-related health outcomes. Among urban populations in the United States, homelessness and other relevant factors had a significant association with reduced adherence levels to antiretroviral therapy in people living with HIV.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"32 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138594398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Syed A. M. Shah, Mahyar Toofantabrizi, Derrick Fox, Ajay Kumar
Listeria monocytogenes (LM) is an intracellular, facultative, gram-positive bacillus transmitted mainly through contaminated food, particularly dairy products and cold deli meats. It typically affects immunocompromised patients, and a rarely neuroinvasive disease in immunocompetent healthy adults has been described in the literature. Despite the timely intervention, neurologic morbidity has been observed after extended periods of recommended antibiotic regimens. This case study highlights the challenges in diagnosing and managing LM meningitis, especially when atypical symptoms and complications arise. Herein, we describe the case of a 57-year-old healthy man admitted with symptoms of nausea, vomiting, headache, neck pain, and stiffness, who was eventually diagnosed with LM-related meningitis and treated with antibiotics. The patient’s hospital course was complicated by bilateral facial nerve palsy, while other symptoms improved with antibiotic treatment, raising suspicion for parainfectious immunological response, which improved with a short course of steroids. This case contributes to the medical literature by providing insights into the immunological response for treating LM meningitis and managing LM meningitis–associated complications. To our knowledge, this could potentially be the first case of LM meningitis causing the parainfectious immunological response of bilateral facial nerve palsy after antibiotic treatment.
{"title":"Bilateral Facial Nerve Palsy Following Antibiotic Treatment for <i>Listeria Monocytogenes</i> Meningitis","authors":"Syed A. M. Shah, Mahyar Toofantabrizi, Derrick Fox, Ajay Kumar","doi":"10.52504/001c.89403","DOIUrl":"https://doi.org/10.52504/001c.89403","url":null,"abstract":"Listeria monocytogenes (LM) is an intracellular, facultative, gram-positive bacillus transmitted mainly through contaminated food, particularly dairy products and cold deli meats. It typically affects immunocompromised patients, and a rarely neuroinvasive disease in immunocompetent healthy adults has been described in the literature. Despite the timely intervention, neurologic morbidity has been observed after extended periods of recommended antibiotic regimens. This case study highlights the challenges in diagnosing and managing LM meningitis, especially when atypical symptoms and complications arise. Herein, we describe the case of a 57-year-old healthy man admitted with symptoms of nausea, vomiting, headache, neck pain, and stiffness, who was eventually diagnosed with LM-related meningitis and treated with antibiotics. The patient’s hospital course was complicated by bilateral facial nerve palsy, while other symptoms improved with antibiotic treatment, raising suspicion for parainfectious immunological response, which improved with a short course of steroids. This case contributes to the medical literature by providing insights into the immunological response for treating LM meningitis and managing LM meningitis–associated complications. To our knowledge, this could potentially be the first case of LM meningitis causing the parainfectious immunological response of bilateral facial nerve palsy after antibiotic treatment.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"62 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134991332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariah C. Estill, Avery Ford, Ruba Omeira, Matthew Rodman
Finasteride and dutasteride are 5-α-reductase inhibitors (5-ARIs) used to treat androgenetic alopecia (AGA). This review evaluates the efficacy of 5-ARIs for treatment of men with AGA and the potential adverse effects on reproduction including sexual dysfunction, infertility, and teratogenicity. A broad literature review was conducted to search for publications on 5-ARI treatment in men with AGA. Hair counts, hair growth assessments, sexual adverse effects (erectile dysfunction, ejaculatory dysfunction, and decreased libido), change in sperm parameters (decreased sperm count, semen volume, sperm motility), and teratogenic drug concentration levels in semen were the measured outcomes of studies included in this literature review. Both finasteride and dutasteride are effective at treating hair loss in male AGA, with studies finding dutasteride was more efficacious than finasteride. Many studies reported sexual adverse effects of 5-ARIs that are uncommon and resolve spontaneously, although there remains no consensus with respect to the presence, severity, and duration of sexual adverse effects. 5-ARIs may have a negative impact on spermatogenesis although the clinical significance of this is unclear and discontinuation of these medications results in improved sperm parameters for most patients. Teratogenicity after paternal exposure is unlikely due to the low concentration of 5-ARIs absorbed in semen. Further research is needed to evaluate the effects of 5-ARI use on reproduction.
{"title":"Finasteride and Dutasteride for the Treatment of Male Androgenetic Alopecia: A Review of Efficacy and Reproductive Adverse Effects","authors":"Mariah C. Estill, Avery Ford, Ruba Omeira, Matthew Rodman","doi":"10.52504/001c.88531","DOIUrl":"https://doi.org/10.52504/001c.88531","url":null,"abstract":"Finasteride and dutasteride are 5-α-reductase inhibitors (5-ARIs) used to treat androgenetic alopecia (AGA). This review evaluates the efficacy of 5-ARIs for treatment of men with AGA and the potential adverse effects on reproduction including sexual dysfunction, infertility, and teratogenicity. A broad literature review was conducted to search for publications on 5-ARI treatment in men with AGA. Hair counts, hair growth assessments, sexual adverse effects (erectile dysfunction, ejaculatory dysfunction, and decreased libido), change in sperm parameters (decreased sperm count, semen volume, sperm motility), and teratogenic drug concentration levels in semen were the measured outcomes of studies included in this literature review. Both finasteride and dutasteride are effective at treating hair loss in male AGA, with studies finding dutasteride was more efficacious than finasteride. Many studies reported sexual adverse effects of 5-ARIs that are uncommon and resolve spontaneously, although there remains no consensus with respect to the presence, severity, and duration of sexual adverse effects. 5-ARIs may have a negative impact on spermatogenesis although the clinical significance of this is unclear and discontinuation of these medications results in improved sperm parameters for most patients. Teratogenicity after paternal exposure is unlikely due to the low concentration of 5-ARIs absorbed in semen. Further research is needed to evaluate the effects of 5-ARI use on reproduction.","PeriodicalId":340325,"journal":{"name":"Georgetown Medical Review","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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