Real-world study of intranasal ketamine for use in patients with refractory chronic migraine: a retrospective analysis.

Introduction: Subanesthetic ketamine infusion has been used for managing refractory headache in inpatient or outpatient infusion settings. Intranasal ketamine may be an alternative option for outpatient care.

Methods: A retrospective study was conducted at a single tertiary headache center to assess the clinical effectiveness and tolerability of intranasal ketamine in patients with refractory chronic migraine.

Cocaine abuse during pregnancy.

Cocaine abuse during pregnancy is a significant public health problem but is infrequently discussed between physicians and patients. The impact of in utero cocaine exposure on pregnancy and the baby has received significant media attention in preceding decades because of fears of teratogenicity, long-term health consequences, and poor cognitive and neurodevelopmental outcomes. We sought to review the medical literature examining these phenomena.

Elevated blood pressure: Our family's fault? The genetics of essential hypertension.

Aim: To provide an updated review on current genetic aspects possibly affecting essential hypertension (EH), and to further elucidate their role in EH.

Methods: We searched for genetic and epigenetic factors in major studies associated with EH between Jan 2008-Oct 2013 using PubMed. We limited our search to reviews that discussed mostly human studies, and were accessible through the university online resource.

Risks of untreated depression in pregnancy.

Question: In my family practice, I tell my female patients of reproductive age who have depression that untreated depression in pregnancy might be more harmful than the unproven risks of antidepressants. However, I recently read in a national news magazine that there is actually no evidence for this advice. Have I missed something?

Answer: You did not miss anything, so you should continue to advise your pregnant patients as before.

Hot yoga and pregnancy: fitness and hyperthermia.

Question: One of my pregnant patients wishes to continue her hot yoga exercises during pregnancy. Is this practice safe?

Answer: With the increased risk of neural tube defects and possibly of other malformations among fetuses exposed to excessive heat, pregnant women should avoid practising hot yoga during pregnancy.

Synthesis of fatty acid ethyl esters in mammalian tissues after ethanol exposure: a systematic review of the literature.

The ability to undergo non-oxidative metabolism from ethanol to fatty acid ethyl esters (FAEEs) varies greatly among tissues and organs. To gain a greater understanding of non-oxidative ethanol metabolism to FAEE, we aimed to collect all published data on FAEE synthesis in mammalian organs and tissues to identify all tissues, organs, and enzymes that are known to, or likely possess FAEE-synthetic activity. A systematic search for relevant papers was performed and two independent reviewers examined potentially relevant abstracts (articles on FAEEs that pertain to ethanol exposure) to determine whether they met the inclusion criteria.

Cocaethylene as a biomarker to predict heavy alcohol exposure among cocaine users.

Background: Cocaethylene (CE) is a cocaine metabolite formed during alcohol and cocaine co-consumption. There are no previous studies to assess the effectiveness of hair CE as a biomarker indicating chronic alcohol consumption among individuals who have consumed cocaine.

Objectives: To establish the ability of CE to predict chronic alcohol use among individuals testing positive for cocaine.

Safety of azathioprine use during pregnancy.

Question: Quite a few of my female patients with rheumatic diseases and inflammatory bowel disease are using azathioprine. They are afraid to take a "cancer drug" during pregnancy. What is known about the risks?

Answer: An increasing body of evidence from prospective cohort studies suggests that azathioprine is safe for the fetus during pregnancy.