Clinicians generally recommend that patients discontinue use of exogenous hormones such as estrogen and testosterone before undergoing surgical procedures, due to the potential increased risk of blood clots and other complications. Yet there’s little evidence to support this practice in transgender people, according to a new systematic review by Elizabeth Boskey, PhD, and her colleagues in the Center for Gender Surgery at Boston Children’s Hospital. In fact, there may be possible psychological harm in requiring trans patients to halt hormone therapy, she says. …Read More
On a Monday morning in late January 2018, surgeons and clinical staff entered the operating room with one primary goal: to forever change the life of the young man who lay before them. More than 14 hours later, the team had made history, performing the first phalloplasty — surgical creation of a penis — for a transgender patient at a major U.S. pediatric hospital. …Read More
Boston Children’s Hospital is at the forefront of clinical research. Stay connected with Paper Trail — a monthly feature highlighting recently published outcomes data and new approaches to the diagnosis, treatment and prevention of pediatric illnesses.
Status epilepticus: Should we treat it like stroke?
Status epilepticus, a state of prolonged seizures, is one of the most common pediatric neurologic emergencies, affecting 10-20% of pediatric epilepsy patients. A new study published in JAMA Neurology underscores the point that rapid treatment improves outcomes and may save lives. “Status epilepticus should be considered a time-sensitive emergency, such as a stroke or other cardiovascular events,” says Tobias Loddenkemper, MD, senior author and director of clinical epilepsy research at Boston Children’s.
Pain management in pediatric acute pancreatitis: Opioid vs. non-opioid
Nearly all patients with acute pancreatitis (AP) experience some degree of severe abdominal pain, yet strategies for pain management in AP have been poorly studied, particularly in the field of pediatrics. Gastroenterology researcher Amit Grover, MD examines the initial provision of analgesia to children who presented to a pediatric emergency department with AP. Learn more in this Journal of Pediatric Gastroenterology and Nutrition paper.
Persistent uterine bleeding in transmasculine and nonbinary teens
The treatment of persistent uterine bleeding can be difficult in a subset of patients who identify as transmasculine or nonbinary. In this recent Transgender Health article, endocrinology researchers Stephanie Roberts, MD and Jeremi Carswell, MD review the physiology of the normal menstrual cycle and the hormonal influences on the endometrium, and explore options for the treatment of persistent bleeding for people both already on testosterone and for those who are either not ready for or who do not desire testosterone.
A practical approach to severe asthma in children
Severe asthma accounts for only a small proportion of the children with asthma, but a disproportionately high amount of resource utilization and morbidity. In a new Annals of the American Thoracic Society paper, senior author and pulmonology researcher Jonathan Gaffin, MD describes the importance of an evidence-based, multidisciplinary approach to treating severe asthma.
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