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Evaluating Assessment Of Melanoma And Non-Melanoma Skin Cancers in Fitzpatricck Skin Types IV-VI
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The U.S Maternal Mortality Health Crisis: Determinants, Impacts, and Interventions
No full textIn the United States, maternal mortality is a concerning issue and has the highest maternal mortality rate among developed countries. The maternal mortality rate has nearly doubled since 2000, and at least half of these deaths are preventable. While pregnancy-related deaths are preventable in America, the maternal mortality rate has steadily rise over the last decade, highlighting the failures of the healthcare system and the inequities faced by women of low socioeconomic backgrounds and color. In the last 20 years, the US has seen a rise in pregnancy-related fatalities. Factors include cardiac problems, bleeding, and chronic medical conditions. Also, unintentional deaths caused by violence, overdose, and self-harming are leading causes of pregnancy-associated deaths. Racial and ethnic disparities are evident with non-Hispanic black women experience three to four times higher rates of pregnancy-related deaths than non-Hispanic white women. The shortage of maternity care providers, particularly midwives, is another critical contributing factor. The US lacks access to provider home visits or paid parental leave during the postpartum period despite a significant proportion of maternal deaths occurring during this time. There is a need for further research to understand the root causes of increased maternal mortality in the United States and to develop targeted interventions to improve maternal health outcomes. Interventions need to include 1) working to eliminate racism in our society and making sure everyone has equal access to essential resources like food, house, and education; 2) making it easier for people to get the medical care they need by improving health insurance and making sure everyone has access to quality healthcare; 3) developing a midwifery model; 4) providing affordable access to birth center; 5) reducing non-communicable disease; 6) public health policy and initiatives; 7) improving data and surveillance; and 8) increasing the availability of telehealth
Management of Acute Back Pain in Military Primary Care: A Clinical Review
No full textAcute low back pain is the leading cause of musculoskeletal disability worldwide and a frequent presentation in military primary care. Effective management is vital in the armed forces, where prolonged pain reduces operational readiness, limits duty performance, and contributes to attrition from physically demanding roles. This review synthesizes evidence from eight high-quality systematic reviews, meta-analyses, and randomized controlled trials identified through PubMed to evaluate the most effective treatments for acute back pain in service members.
The strongest evidence supports pharmacologic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and non-benzodiazepine muscle relaxants. NSAIDs are particularly relevant in military practice because they are readily available in garrison clinics and austere environments through the Joint First Aid Kit (JFAK), enabling rapid pain relief even in deployed settings. Combination therapy has been shown to provide superior outcomes compared with single agents, with minimal adverse effects.
Non-pharmacologic interventions also demonstrate benefit. Structured physical therapy, exercise programs, and patient education improve pain and function while reducing the risk of chronicity. Battlefield acupuncture (BFA) provides a non-drug option that avoids cognitive impairment and has shown effectiveness in both clinical and operational environments, although training and certification requirements remain barriers to widespread adoption.
Despite the availability of multiple effective therapies, acute back pain remains a major challenge in military populations. Comparative trials tailored to military settings are needed to define optimal strategies that prevent back pain, reduce recurrence, accelerate recovery, and preserve operational readiness
Postpartum Depression and Child Developmental Risk in Minority Populations
No full textABSTRACT
Postpartum depression (PPD) is a common complication of childbirth, affecting approximately one in seven women. Minority women are disproportionately underdiagnosed and undertreated, which increases risks for both maternal health and child development. The purpose of this review was to examine the prevalence of PPD among minority women, its impact on early developmental outcomes, and clinical strategies to reduce disparities.
A literature search was conducted in PubMed and Google Scholar for studies published between 2019 and 2025. Eligible articles included observational cohorts, case–control studies, surveys, and systematic reviews reporting on PPD prevalence in minority women or associations with child outcomes up to 36 months. Outcomes included maternal well-being, bonding, and child development in cognitive, language, motor, and social-emotional domains.
Findings showed that untreated PPD is linked to developmental delays and higher behavioral risk, particularly when symptoms are severe or persistent. Minority women face additional barriers to diagnosis and care, including stigma, limited culturally responsive screening, and systemic inequities. Evidence supports repeated screening with the Edinburgh Postnatal Depression Scale (EPDS), timely access to psychotherapy such as cognitive behavioral therapy (CBT) or interpersonal therapy (IPT), and selective serotonin reuptake inhibitors (SSRIs) compatible with lactation. Culturally tailored interventions and expanded access through mid-level practitioners are critical to reducing disparities.
Keywords: Postpartum depression, minority women, maternal mental health, child development, health disparities, early interventio
Human Chorionic Gonadotropin or Traditional Testosterone Replacement For Male Hypogonadism – Is one better than the other?
No full textABSTRACT
This narrative review examines diagnostic and treatment strategies for testosterone deficiency in aging men, which often presents with nonspecific symptoms—fatigue, low libido, mood disturbances—that poorly correlate with serum testosterone levels, particularly when values fall in the borderline range of 300–350 ng/dL, complicating clinical assessment. While testosterone replacement therapy (TRT) remains the standard for men with total testosterone \u3c 300 ng/dL, it suppresses spermatogenesis and may jeopardize fertility. Human chorionic gonadotropin (hCG) offers a fertility‐preserving alternative by sustaining endogenous testosterone production and maintaining sperm counts. We evaluate diagnostic thresholds—including an Aging Male Symptom (AMS) and symptom‐based assessment tools, advocating for standardized instruments to complement biochemical markers. Evidence suggests hCG monotherapy may alleviate hypogonadal symptoms in men with borderline testosterone levels, though long-term luteinizing hormone receptor responsiveness warrants further study. Adjunctive agents—including selective estrogen-receptor modulators, aromatase inhibitors, and selective androgen-receptor modulators—are increasingly used for post-androgenic recovery and anabolic steroid–induced hypogonadism, now showing promise in restoring endogenous testosterone and improving clinical outcomes. A personalized approach integrating diagnostic precision, systematic biomarker surveillance, and fertility-conscious treatment regimens is essential for optimizing care in hypogonadal men