Pedophilic Behavior from Brain Disease

Author links open overlay panelMarioMendezMD, PhD*†Jill S.ShapiraRN, PhD‡
*
VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
†
UCLA—Neurology & Psychiatry, UCLA Medical Plaza, Los Angeles, CA, USA
‡
UCLA—Neurology, Los Angeles, CA, USA
Available online 16 December 2015.

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https://doi.org/10.1111/j.1743-6109.2010.02172.xGet rights and content
ABSTRACT
Introduction
Child molestation or other pedophilic behavior may result as a consequence of a brain disorder.

Aim
To characterize the mechanisms of pedophilic behavior associated with neurological diseases.

Methods
We report eight patients with pedophilic behavior as a manifestation of their brain disorder and review the literature.

Main Outcome Measures
The sexual, neuropsychiatric, and neurological aspects of a series of patients.

Results
All eight developed sexual behavior toward prepubescent children in mid‐ to late‐life coincident with the development of a neurological disorder. Five had limited insight, anxiety, or concern for their behavior and tended to have frontal lobe executive deficits. Most of this group had frontally predominant disorders. Two others retained insight and concern in the context of marked hypersexuality. This second group had treated Parkinson's disease and resembled reports of pedophilic behavior from subcortical lesions. The further presence of right temporal lobe‐amygdala involvement may have predisposed to specific sexual preoccupation in some patients.

Conclusions
Brain disorders may release a predisposition to sexual attraction for children through disinhibition with frontal disease, sexual preoccupation with right temporal disease, or hypersexuality with subcortical disease in non‐motor basal ganglia, hypothalamus, or septal nuclei. Differentiating these mechanisms of pedophilic behavior from brain disease could facilitate targeted interventions. Mendez M and Shapira JS. Pedophilic behavior from brain disease.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Hypersexual behavior in frontotemporal dementia

: a comparison with early-onset Alzheimer's disease.
Mendez MF1, Shapira JS.
Author information
1
Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, 300 Medical Plaza, Suite B-200, Box 956975, Los Angeles, CA 90095-6975, USA. mmendez@ucla.edu
Abstract
The basis of hypersexual behavior among patients with dementia is not entirely clear. Hypersexual behavior may be a particular feature of behavioral variant frontotemporal dementia (bvFTD), which affects ventromedial frontal and adjacent anterior temporal regions specialized in interpersonal behavior. Recent efforts to define hypersexual disorder indicate an increasing awareness of heightened sexual activity as a source of personal distress and functional impairment, and clarification of hypersexuality in bvFTD could contribute to understanding the neurobiology of this behavior. This study reviewed 47 patients with bvFTD compared to 58 patients with Alzheimer's disease (AD) for the presence of heightened sexual activity to the point of distress to caregivers and others. Hypersexual behavior occurred in 6 (13 %) bvFTD patients compared to none of the AD patients. Caregivers judged all six bvFTD patients with hypersexual behavior as having a dramatic increase in sexual frequency from premorbid levels. All had general disinhibition, poor impulse control, and actively sought sexual stimulation. They had widened sexual interests and experienced sexual arousal from previously unexciting stimuli. One patient, with early and predominant right anterior temporal involvement, was easily aroused by slight stimuli, such as touching her palms. Although previously considered to be predominantly disinhibited sexual behavior as part of generalized disinhibition, these patients with dementia illustrate varying degrees of increased sexual desire. We conclude that bvFTD is uniquely associated with hypersexuality; it is more than just cognitive impairment with frontal disinhibition but also involves alterations in sexual drive, possibly from right anterior temporal- limbic involvement in this disease.

PMID: 23297146 PMCID: PMC3596488 DOI: 10.1007/s10508-012-0042-4

1.

Figure 1. From: Hypersexual Behavior in Frontotemporal Dementia: A Comparison with Early-Onset Alzheimer's Disease.

Magnetic resonance imaging (MRI) of the brain for Patient No. 6. The upper left is an axial flair image showing anterior temporal areas of atrophy and gliosis, with the right side involved to a much greater degree than the left. The upper right is an axial T2 imaging of the same findings. The lower right is an axial flair image at a slightly higher level. The lower left is a saggital FLAIR image showing atrophy extending to the medial frontal region consistent with bvFTD.

Mario F. Mendez, et al. Arch Sex Behav. ;42(3):501-509.

CitationFull text

2.

Figure 2. From: Hypersexual Behavior in Frontotemporal Dementia: A Comparison with Early-Onset Alzheimer's Disease.

Single photon emission tomography (SPECT) imaging of the brain for Patient No. 6. The images are, left to right, axial, coronal, saggital, and 3-dimensional (3-D) reconstructions of the SPECT images. They show disproprtionate hypoperfusion of the right frontotemporal region with relative sparing of the left. There is clear involvement of the right anterior temporal area extending to adjacent frontal areas. The 3-D reconstructions illustrate a lateral view of the right hemisphere in the upper right and a corresponding lateral view of the left hemisphere in the lower right.

Mario F. Mendez, et al. Arch Sex Behav. ;42(3):501-509.

CitationFull text

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Criminal behavior in frontotemporal dementia and Alzheimer disease

Liljegren M1, Naasan G2, Temlett J3, Perry DC2, Rankin KP2, Merrilees J2, Grinberg LT2, Seeley WW2, Englund E1, Miller BL2.
Author information
1
Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden.
2
Memory and Aging Center, Department of Neurology, University of California, San Francisco.
3
Department of Medicine, University of Notre Dame, Fremantle, Australia.
Abstract
IMPORTANCE:
Neurodegenerative diseases can cause dysfunction of neural structures involved in judgment, executive function, emotional processing, sexual behavior, violence, and self-awareness. Such dysfunctions can lead to antisocial and criminal behavior that appears for the first time in the adult or middle-aged individual or even later in life.

OBJECTIVE:
To investigate the frequency and type of criminal behavior among patients with a diagnosed dementing disorder.

DESIGN, SETTING, AND PARTICIPANTS:
We conducted a retrospective medical record review of 2397 patients who were seen at the University of California, San Francisco, Memory and Aging Center between 1999 and 2012, including 545 patients with Alzheimer disease (AD), 171 patients with behavioral variant of frontotemporal dementia (bvFTD), 89 patients with semantic variant of primary progressive aphasia, and 30 patients with Huntington disease. Patient notes containing specific keywords denoting criminal behavior were reviewed. Data were stratified by criminal behavior type and diagnostic groups.

MAIN OUTCOMES AND MEASURES:
Frequencies of criminal behavior and χ² statistics were calculated.

RESULTS:
Of the 2397 patients studied, 204 (8.5%) had a history of criminal behavior that emerged during their illness. Of the major diagnostic groups, 42 of 545 patients (7.7%) with AD, 64 of 171 patients (37.4%) with bvFTD, 24 of 89 patients (27.0%) with semantic variant of primary progressive aphasia, and 6 of 30 patients (20%) with Huntington disease exhibited criminal behavior. A total of 14% of patients with bvFTD were statistically significantly more likely to present with criminal behavior compared with 2% of patients with AD (P < .001) and 6.4% were statistically significantly more likely to exhibit violence compared with 2% of patients with AD (P = .003). Common manifestations of criminal behavior in the bvFTD group included theft, traffic violations, sexual advances, trespassing, and public urination in contrast with those in the AD group, who commonly committed traffic violations, often related to cognitive impairment.

CONCLUSIONS AND RELEVANCE:
Criminal behavior is more common in patients with bvFTD and semantic variant of primary progressive aphasia than in those with AD and is more likely to be an early manifestation of the disorder. Judicial evaluations of criminality in the demented individual might require different criteria than the classic "insanity defense" used in the American legal system; these individuals should be treated differently by the law. The appearance of new-onset criminal behavior in an adult should elicit a search for frontal and anterior temporal brain disease and for dementing disorders.

Comment in
Dementia. Criminality can be an early sign of frontotemporal dementia. [Nat Rev Neurol. 2015]
PMID: 25559744 PMCID: PMC4432918 DOI: 10.1001/jamaneurol.2014.3781

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Sexual Behavior

Sexual Science versus Progressive Advocacy: The Need for Resistance

Tracking Mouse Trajectories Related to Decisions About Sexual Interest Abstract The current research explored continuous behavioral processes by recording participants' hand movements toward a response option using Mousetracker software. Across three studies, we tested the idea that sexual interest-related decisions can be indexed using automatic movements. Using a UK sample of self-identified same- and opposite-gender attracted men (N = 43), Study 1 showed that the process of approaching the response button was faster, more direct, and less curved when participants responded from their own (vs. a non-preferred) perspective. Study 2 supported these findings using a German sample of self-identified same- and opposite-gender attracted men (N = 66). Using a teleiophilic sample of 100 self-identified opposite-gender attracted men (n = 51) and women (n = 49), Study 3 examined age-specific sexual interests (i.e., responding to stimuli from a pedophilic and a teleiophilic perspective). As expected, in the teleiophilic block, participants' responses were faster, more direct, and less curved than in the pedophilic block. Collectively, the results suggest that mousetracking shows promise as a measure of sexual interest (across the dimension of both gender and age), providing grounds for future research.

Identifying Basic Classes of Sexual Orientation with Latent Profile Analysis: Developing the Multivariate Sexual Orientation Classification System Abstract Despite considerable progress, research on sexual minorities has been hindered by a lack of clarity and consistency in defining sexual minority groups. Further, despite recent recommendations to assess the three main dimensions of sexual orientation—identity, behavior, and attraction—it remains unclear how best to integrate such multivariate information to define discrete sexual orientation groups, particularly when identity and behavior fail to match. The current study used a data-driven approach to identify a parsimonious set of sexual orientation classes. Latent profile analysis (LPA) was run within a large (N = 3182) and sexually diverse sample, using dimensions of sexual identity, behavior, and attraction as predictors. LPAs supported four fundamental sexual orientation classes not only in the overall sample, but also when conducted separately in men (n = 980) and women (n = 2175): heterosexual, homosexual, bisexual, and heteroflexible (a class representing individuals who self-identify as heterosexual or mostly heterosexual but report moderate same-sex sexual behavior and attraction). Heterosexuals reported the highest levels of psychological functioning and lowest risk behaviors. Homosexuals showed similarly high levels of psychological functioning to heterosexuals, but higher levels of risk behaviors. Bisexuals and heteroflexibles showed similarly low levels of psychological functioning and high risk taking. To facilitate applications of this classification approach, the study developed the Multivariate Sexual Orientation Classification System, reproducing the four LPA groups with 97% accuracy (kappa = .95) using just two items. Implications of this classification approach are discussed.

Exploratory Factor Analysis of Two Sexual Health Scales for Transgender People: Trans-Specific Condom/Barrier Negotiation Self-Efficacy (T-Barrier) and Trans-Specific Sexual Body Image Worries (T-Worries) Abstract Few sexual health measures have been validated for transgender (trans) populations. Condom/barrier self-efficacy and sexual body image worries are interrelated constructs that may contribute to enhanced and poor sexual health, respectively. We report on the development and initial validation of trans-specific scales designed to measure these constructs. Trans people in Ontario, Canada, who had ever had sex completed these scales as a part of a larger Trans PULSE survey (n = 323). Using exploratory factor analysis, a one-factor solution fit the 8-item Condom/Barrier Negotiation Self-Efficacy Scale (T-Barrier). Two factors were identified for the 7-item Sexual Body Image Worries Scale (T-Worries): "general body image worries" and "trans-related image worries," while two items were recommended for deletion. The scales demonstrated convergent validity with measures such as self-esteem, sexual anxiety, sexual satisfaction, sexual fear, and experiences of transphobia. Further evaluation to confirm these structures within an independent trans sample would be valuable. We recommend the use of these scales for studies of sexual health within trans populations, to enhance our ability to better understand and promote sexual health within trans communities.

Correction to: Sexual Identity and Behavior Among U.S. High School Students, 2005–2015 The following correction should be noted to the caption of Fig. 1 in this article.

Richard Green, M.D., J.D. (1936–2019)

Using Photovoice to Understand Suicidality Among Gay, Bisexual, and Two-Spirit Men Abstract This study explored the drivers of suicidality from the perspectives of gay, bisexual, and two-spirit men (GB2SM) with a history of suicidality. Twenty-one GB2SM participated in this photovoice study taking photographs to depict and discuss their previous suicidality. Data were collected from in-depth individual interviews in which participants discussed their photographs and in turn offered verbal/narrative accounts of suicidality. Drawing on intersectionality, analyses of the photographs and interview data revealed three interconnected themes. First, adverse childhood events and negative adolescent experiences were described as the root causes of mental health struggles and suicidality. Second, violence and homophobia had disrupted these men's education and employment opportunities and some participants detailed how their lack of capital and challenges for maintaining employment shaped their suicidality. Third, a sociality of stigma and sense of isolation compounded experiences of suicidality. The three themes overlapped and were shaped by multiple intersectional axes including sexuality, class, ethnicity, and mental health status. The findings have implications for services and health professionals working with GB2SM who need to thoughtfully consider life-course trajectories and multiple social axes when assessing and treating GB2SM experiencing suicidality. More so, because these factors relate to social inequities, structural and policy changes warrant targeted attention.

Power and Privilege in the Field of Sexuality Research and Beyond

Uncertainty and Posttraumatic Stress: Differences Between Mothers and Fathers of Infants with Disorders of Sex Development Abstract Parents of children with disorders of sex development (DSD) report significant psychological distress, including posttraumatic stress symptoms (PTSS), with mothers consistently reporting higher rates of psychological distress than fathers. However, psychological factors contributing to PTSS in both parents are not well understood. The present study sought to fill this gap in knowledge by examining PTSS and illness uncertainty, a known predictor of psychological distress, in parents of children recently diagnosed with DSD. Participants were 52 mothers (Mage = 32.55 years, SD = 5.08) and 41 fathers (Mage = 35.53 years, SD = 6.78) of 53 infants (Mage = 9.09 months, SD = 6.19) with DSD and associated atypical genital development. Participants were recruited as part of a larger, multisite study assessing parents' psychosocial response to their child's diagnosis of DSD. Parents completed measures of illness uncertainty and PTSS. Mothers reported significantly greater levels of PTSS, but not illness uncertainty, than fathers, and were more likely than fathers to report clinical levels of PTSS (21.2% compared to 7.3%). Hierarchical regression revealed that parent sex, undiagnosed or unclassified DSD status, and illness uncertainty were each associated with PTSS. The overall model accounted for 23.5% of the variance associated with PTSS. Interventions targeting illness uncertainty may be beneficial for parents of children with newly diagnosed DSD.

Visual Attention to Sexual Stimuli in Mostly Heterosexuals Abstract Individuals who report mostly heterosexual orientations (i.e., mostly sexually attracted to the opposite sex, but occasionally attracted to the same sex) outnumber all other non-heterosexual individuals combined. The present study examined whether mostly heterosexual men and women view same- and other-sex sexual stimuli differently than exclusively heterosexual men and women. A novel eye-tracking paradigm was used with 162 mostly and exclusively heterosexual men and women. Compared to exclusively heterosexual men, mostly heterosexual men demonstrated greater attention to sexually explicit features (i.e., genital regions and genital contact regions) of solo male and male–male erotic stimuli, while demonstrating equivalent attention to sexually explicit features of solo female and female–female erotic stimuli. Mediation analyses suggested that differences between mostly and exclusively heterosexual profiles in men could be explained by mostly heterosexual men's increased sexual attraction to solo male erotica, and their increased sexual attraction and reduced disgust to the male–male erotica. No comparable differences in attention were observed between mostly and exclusively heterosexual women—although mostly heterosexual women did demonstrate greater fixation on visual erotica overall—a pattern of response that was found to be mediated by reduced disgust.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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Vision rehabilitation interventions following mild traumatic brain injury: a scoping reviewMary E. Simpson-Jones & Anne W. HuntPages 2206-2222 | Received 11 Oct 2017, Accepted 29 Mar 2018, Published online: 10 Apr 2018Download citation  https://doi.org/10.1080/09638288.2018.1460407  Select Language▼Translator disclaimerAbstractPurpose: To broadly examine the literature to identify vision interventions following mild traumatic brain injury. Objectives are to identify: (1) evidence-informed interventions...

Αλέξανδρος Γ. Σφακιανάκης

13m

Is My Child Allergic to Penicillin? Kimberly G. Blumenthal, MD, MSc; Erica S. Shenoy, MD, PhD Article...

Is My Child Allergic to Penicillin?Kimberly G. Blumenthal, MD, MSc; Erica S. Shenoy, MD, PhDArticle InformationJAMA Pediatr. Published online May 28, 2019. doi:10.1001/jamapediatrics.2019.1402Penicillin is the most commonly used antibiotic in children.Most children labeled with a penicillin allergy are not truly allergic; however, the label leads to use of alternative antibiotics that have been associated with increased risk of treatment failures, resistant bacteria, serious adverse events, and Clostridium...

Αλέξανδρος Γ. Σφακιανάκης

16m

Dengue Vaccine Gets the Nod Rebecca Voelker, MSJ JAMA. 2019;321(21):2066. doi:10.1001/jama.2019.6886...

Dengue Vaccine Gets the NodRebecca Voelker, MSJJAMA. 2019;321(21):2066. doi:10.1001/jama.2019.6886The FDA has approved the first vaccine to prevent disease caused by all 4 dengue virus serotypes. The vaccine is indicated only for children and teens aged 9 to 16 years living in endemic areas who have had a previous, laboratory-confirmed dengue infection.Although dengue cases are rare in the continental United States, the disease is found regularly in American Samoa, Puerto Rico, Guam, the US Virgin...

Αλέξανδρος Γ. Σφακιανάκης

17m

Kratom-Related Deaths Bridget Kuehn, MSJ JAMA. 2019;321(20):1966. doi:10.1001/jama.2019.6339 More than...

Kratom-Related DeathsBridget Kuehn, MSJJAMA. 2019;321(20):1966. doi:10.1001/jama.2019.6339More than 90 deaths in the United States have been caused by kratom between July 2016 and December 2017, according to a CDC report. Image description not available.iStock.com/Iryna ImagoKratom (Mitragyna speciosa), a plant native to Southeast Asia, has been growing in popularity as an herbal supplement. Consuming low doses of it may have stimulant-like effects, while higher doses may produce opioid-like effects,...

Αλέξανδρος Γ. Σφακιανάκης

18m

Guidelines for Perioperative Care in Cardiac Surgery Enhanced Recovery After Surgery Society Recommendations...

Guidelines for Perioperative Care in Cardiac SurgeryEnhanced Recovery After Surgery Society RecommendationsDaniel T. Engelman, MD1; Walid Ben Ali, MD2; Judson B. Williams, MD, MHS3; et al Louis P. Perrault, MD, PhD2; V. Seenu Reddy, MD4; Rakesh C. Arora, MD, PhD5,15; Eric E. Roselli, MD6; Ali Khoynezhad, MD, PhD7; Marc Gerdisch, MD8; Jerrold H. Levy, MD9; Kevin Lobdell, MD10; Nick Fletcher, MD, MBBS11; Matthias Kirsch, MD12; Gregg Nelson, MD13; Richard M. Engelman, MD16; Alexander J. Gregory, MD13;...

Αλέξανδρος Γ. Σφακιανάκης

19m

Multimodal Imaging of Isolated Choroidal Infarction Following Injection of Facial Filler Pamela Sherwood, MD1; Lediana Goduni, MD1; Tahsin Khundkar, MD2; et...

Multimodal Imaging of Isolated Choroidal Infarction Following Injection of Facial FillerPamela Sherwood, MD1; Lediana Goduni, MD1; Tahsin Khundkar, MD2; et alBrandon Johnson, MD1,3; Benjamin Erickson, MD4; Yasha Modi, MD1Author Affiliations Article InformationJAMA Ophthalmol. Published online May 23, 2019. doi:10.1001/jamaophthalmol.2019.1422Dermal facial filler injections, especially in the perinasal and glabellar regions, confer a particularly high risk of retrograde passage of filler material...

Αλέξανδρος Γ. Σφακιανάκης

20m

Diffuse Hyperpigmentation in a Patient With an Axillary Mass Shruti Bhandari, MD1; Prashant Tripathi, MD2; Hamza Hashmi, MD1...

Diffuse Hyperpigmentation in a Patient With an Axillary MassShruti Bhandari, MD1; Prashant Tripathi, MD2; Hamza Hashmi, MD1Author Affiliations Article InformationJAMA Oncol. Published online May 23, 2019. doi:10.1001/jamaoncol.2019.0524CaseAwhite man in his early 40s with a medical history of chronic lymphocytic leukemia (Rai stage 0) reported a 6-month history of a growing mass in his right axilla and weight loss. Physical examination revealed palpable right axillary lymphadenopathy. The patient...

Αλέξανδρος Γ. Σφακιανάκης

21m

Acute Treatment of Patients With Supraventricular Tachycardia Sana M. Al-Khatib, MD, MHS1; Richard...

Acute Treatment of Patients With Supraventricular TachycardiaSana M. Al-Khatib, MD, MHS1; Richard L. Page, MD2Author Affiliations Article InformationJAMA Cardiol. 2016;1(4):483-485. doi:10.1001/jamacardio.2016.1483Guideline title: 2015 American College of Cardiology/American Heart Association/Heart Rhythm Society Guideline for the Management of Adult Patients With Supraventricular TachycardiaDevelopers: American College of Cardiology, American Heart Association, and Heart Rhythm SocietyRelease dates:...

Αλέξανδρος Γ. Σφακιανάκης

21m

on the Management of Blood Cholesterol Primary Prevention Scott M. Grundy, MD, PhD1; Neil J. Stone,...

on the Management of Blood CholesterolPrimary PreventionScott M. Grundy, MD, PhD1; Neil J. Stone, MD2Author Affiliations Article InformationJAMA Cardiol. 2019;4(5):488-489. doi:10.1001/jamacardio.2019.0777related articles icon RelatedArticlesGuideline title: 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood CholesterolDevelopers: American College of Cardiology (ACC) and American Heart Association (AHA)Release date: November 10, 2018Prior version: November...

Αλέξανδρος Γ. Σφακιανάκης

22m

Menopausal Hormone Therapy Jan L. Shifren, MD1; Carolyn J. Crandall, MD, MS2,3; JoAnn E. Manson, MD,...

Menopausal Hormone TherapyJan L. Shifren, MD1; Carolyn J. Crandall, MD, MS2,3; JoAnn E. Manson, MD, DrPH4,5Author Affiliations Article InformationJAMA. Published online May 30, 2019. doi:10.1001/jama.2019.5346editorial comment icon EditorialCommentmultimedia icon MultimediaClinical Review Audio (29:33)Menopausal Hormone TherapyHormone therapy is the most effective treatment for managing menopausal vasomotor symptoms. Hot flashes and night sweats affect approximately 70% of midlife women and may persist...

Αλέξανδρος Γ. Σφακιανάκης

23m

In-Flight Medical Emergencies A Review Christian Martin-Gill, MD, MPH1; Thomas J. Doyle, MD, MPH1;...

In-Flight Medical EmergenciesA ReviewChristian Martin-Gill, MD, MPH1; Thomas J. Doyle, MD, MPH1; Donald M. Yealy, MD1Author Affiliations Article InformationJAMA. 2018;320(24):2580-2590. doi:10.1001/jama.2018.19842related articles icon RelatedArticlesmultimedia icon MultimediaClinical Review Audio (29:22)Medical Emergencies While FlyingAbstractImportance  In-flight medical emergencies (IMEs) are common and occur in a complex environment with limited medical resources. Health care personnel are often...

Αλέξανδρος Γ. Σφακιανάκης

24m

Characterization of Injury Induced by Routine Surgical Manipulations of Nasal Septal Cartilage William...

Characterization of Injury Induced by Routine Surgical Manipulations of Nasal Septal CartilageWilliam W. Thomas, MD1; Robert M. Brody, MD1; Abdullah D. Alotaibi, MD1,2; et al Emilie C. Rabut, BS2; Noam A. Cohen, MD, PhD1,3; Robert Lyman, MD2; Milos Kovacevic, MD4; Oren Friedman, MD1; George R. Dodge, PhD1,2,5Author Affiliations Article InformationJAMA Facial Plast Surg. Published online May 30, 2019. doi:10.1001/jamafacial.2019.0169author interview icon InterviewsAudio Interview (16:09)Characterization...

Αλέξανδρος Γ. Σφακιανάκης

25m

Risk of Serious Infection in Patients Receiving Systemic Medications for the Treatment of Psoriasis...

Risk of Serious Infection in Patients Receiving Systemic Medications for the Treatment of PsoriasisErica D. Dommasch, MD, MPH1,2,3; Seoyoung C. Kim, MD, ScD, MSCE2,3; Moa P. Lee, PharmD, MPH3,4; et al Joshua J. Gagne, PharmD, ScD2,3Author Affiliations Article InformationJAMA Dermatol. Published online May 10, 2019. doi:10.1001/jamadermatol.2019.1121Key PointsQuestion  What are the risks of serious infection with systemic medications used for the treatment of psoriasis?Findings  In this comparative...

Αλέξανδρος Γ. Σφακιανάκης

26m

Association of Antipsychotic Polypharmacy vs Monotherapy With Psychiatric Rehospitalization Among Adults...

Association of Antipsychotic Polypharmacy vs Monotherapy With Psychiatric Rehospitalization Among Adults With SchizophreniaJari Tiihonen, MD, PhD1,2,3; Heidi Taipale, PhD1,2,4; Juha Mehtälä, PhD5; et al Pia Vattulainen, MSc5; Christoph U. Correll, MD6,7,8; Antti Tanskanen, PhLic1,2,9Author Affiliations Article InformationJAMA Psychiatry. 2019;76(5):499-507. doi:10.1001/jamapsychiatry.2018.4320editorial comment icon EditorialCommentrelated articles icon RelatedArticlesKey PointsQuestion  Are there...

Αλέξανδρος Γ. Σφακιανάκης

26m

Total Neoadjuvant Therapy With FOLFIRINOX in Combination With Losartan Followed by Chemoradiotherapy...

Total Neoadjuvant Therapy With FOLFIRINOX in Combination With Losartan Followed by Chemoradiotherapy for Locally Advanced Pancreatic CancerA Phase 2 Clinical TrialJanet E. Murphy, MD, MPH1; Jennifer Y. Wo, MD2; David P. Ryan, MD1; et al Jeffrey W. Clark, MD1; Wenqing Jiang, MS1; Beow Y. Yeap, SciD1; Lorraine C. Drapek, DNP2; Leilana Ly, BA2; Christian V. Baglini, BA2; Lawrence S. Blaszkowsky, MD1; Cristina R. Ferrone, MD3; Aparna R. Parikh, MD1; Colin D. Weekes, MD, PhD1; Ryan D. Nipp, MD1; Eunice...

Αλέξανδρος Γ. Σφακιανάκης

27m

Association of Nonfasting vs Fasting Lipid Levels With Risk of Major Coronary Events in the Anglo-Scandinavian...

Association of Nonfasting vs Fasting Lipid Levels With Risk of Major Coronary Events in the Anglo-Scandinavian Cardiac Outcomes Trial–Lipid Lowering ArmSamia Mora, MD, MHS1,2; C. Lan Chang, PhD3; M. Vinayaga Moorthy, PhD1; et al Peter S. Sever, PhD, FRCP3Author Affiliations Article InformationJAMA Intern Med. Published online May 28, 2019. doi:10.1001/jamainternmed.2019.0392Key PointsQuestion  How do nonfasting lipid levels compare with fasting lipid levels measured in the same individuals for assessing...

Αλέξανδρος Γ. Σφακιανάκης

28m

Clinical Performance Evaluation of a Personal Sound Amplification Product vs a Basic Hearing Aid and...

Clinical Performance Evaluation of a Personal Sound Amplification Product vs a Basic Hearing Aid and a Premium Hearing AidYoung Sang Cho, MD1,2; Su Yeon Park, BS2; Hye Yoon Seol, AuD2; et al Ji Hyun Lim, BS3; Yang-Sun Cho, MD, PhD1,2; Sung Hwa Hong, MD, PhD2,4; Il Joon Moon, MD, PhD1,2Author Affiliations Article InformationJAMA Otolaryngol Head Neck Surg. Published online May 16, 2019. doi:10.1001/jamaoto.2019.0667editorial comment icon EditorialCommentKey PointsQuestion  For adults with mild to...

Αλέξανδρος Γ. Σφακιανάκης

29m

Brand-Name Prescription Drugs

Trends in Prices of Popular Brand-Name Prescription Drugs in the United StatesNathan E. Wineinger, PhD1; Yunyue Zhang, BA1; Eric J. Topol, MD1Author Affiliations Article InformationJAMA Netw Open. 2019;2(5):e194791. doi:10.1001/jamanetworkopen.2019.4791Key Points Español  中文 (Chinese)Question  What are the prices of top-selling brand-name prescription drugs in the United States, and how have these prices changed in recent years?Findings  In this economic evaluation of 49 common top-selling brand-name...

Αλέξανδρος Γ. Σφακιανάκης

29m

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Association of Increased Youth Suicides in the United States With the Release of 13 Reasons Why Thomas...

Association of Increased Youth Suicides in the United States With the Release of 13 Reasons WhyThomas Niederkrotenthaler, MD, PhD, MMSc1; Steven Stack, PhD2; Benedikt Till, DSc1; et al Mark Sinyor, MSc, MD3,4; Jane Pirkis, PhD5,6; David Garcia, DSc7,8; Ian R. H. Rockett, PhD, MPH9,10; Ulrich S. Tran, DSc11Author Affiliations Article InformationJAMA Psychiatry. Published online May 29, 2019. doi:10.1001/jamapsychiatry.2019.0922editorial comment icon EditorialCommentauthor interview icon InterviewsAudio...

Αλέξανδρος Γ. Σφακιανάκης

30m

Association Between Statin Use and Risk of Dementia After a Concussion Donald A. Redelmeier, MD, MSHSR1,2,3,4,5;...

Association Between Statin Use and Risk of Dementia After a ConcussionDonald A. Redelmeier, MD, MSHSR1,2,3,4,5; Fizza Manzoor, BHSc1,2,3; Deva Thiruchelvam, MSc3Author Affiliations Article InformationJAMA Neurol. Published online May 20, 2019. doi:10.1001/jamaneurol.2019.1148editorial comment icon EditorialCommentauthor interview icon InterviewsAudio Interview (15:53)Association Between Statin Use and Risk of Dementia After a ConcussionKey PointsQuestion  Is statin use associated with an increased...

Αλέξανδρος Γ. Σφακιανάκης

31m

Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years Aliya Alimujiang,...

Association Between Life Purpose and Mortality Among US Adults Older Than 50 YearsAliya Alimujiang, MPH1; Ashley Wiensch, MPH1; Jonathan Boss, MS2; et al Nancy L. Fleischer, PhD, MPH1; Alison M. Mondul, PhD, MPH1; Karen McLean, MD, PhD3; Bhramar Mukherjee, PhD1,2; Celeste Leigh Pearce, PhD, MPH1Author Affiliations Article InformationJAMA Netw Open. 2019;2(5):e194270. doi:10.1001/jamanetworkopen.2019.4270Key Points Español  中文 (Chinese)Question  Does an association exist between life purpose and all-cause...

Αλέξανδρος Γ. Σφακιανάκης

32m

Association of Step Volume and Intensity With All-Cause Mortality in Older Women I-Min Lee, MBBS, ScD1,2;...

Association of Step Volume and Intensity With All-Cause Mortality in Older WomenI-Min Lee, MBBS, ScD1,2; Eric J. Shiroma, ScD3; Masamitsu Kamada, PhD4; et al David R. Bassett, PhD5; Charles E. Matthews, PhD6; Julie E. Buring, ScD1,2Author Affiliations Article InformationJAMA Intern Med. Published online May 29, 2019. doi:10.1001/jamainternmed.2019.0899Key PointsQuestion  Are increased numbers of steps per day associated with lower mortality rates among older women?Findings  In this cohort study of...

Αλέξανδρος Γ. Σφακιανάκης

33m

Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active...

Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active IngredientsA Randomized Clinical TrialMurali K. Matta, PhD1; Robbert Zusterzeel, MD, PhD, MPH1; Nageswara R. Pilli, PhD1; et al Vikram Patel, PhD1; Donna A. Volpe, PhD1; Jeffry Florian, PhD1; Luke Oh, PhD2; Edward Bashaw, PharmD2; Issam Zineh, PharmD, MPH2; Carlos Sanabria, MD3; Sarah Kemp, RN3; Anthony Godfrey, PharmD3; Steven Adah, PhD4; Sergio Coelho, PhD4; Jian Wang, PhD5; Lesley-Anne Furlong,...

Αλέξανδρος Γ. Σφακιανάκης

33m

Massachusetts General Hospital, and Harvard Medical School discusses menopausal symptoms

Download MP3Subscribe to PodcastJan L. Shifren, MD, from the department of obstetrics and gynecology, Massachusetts General Hospital, and Harvard Medical School discusses menopausal symptoms such as hot flashes and how they can be effectively treated by the administration of hormones when given appropriately.RelatedUse of Menopausal Hormone Therapy in 2019

Αλέξανδρος Γ. Σφακιανάκης

42m

COPD: All You Need to Know in 20 Minutes Educational Objective To understand how to diagnose and manage...

COPD: All You Need to Know in 20 MinutesEducational ObjectiveTo understand how to diagnose and manage COPD.Download MP3Subscribe to PodcastCOPD is common enough that it is responsible for 3% of all clinic visits in the United States. Clinicians will undoubtedly deal with this disease in their practice. How to diagnose and manage it is reviewed by Frank C. Sciurba, MD, a professor of medicine from the University of Pittsburgh, Pennsylvania.RelatedDiagnosis and Outpatient Management of Chronic Obstructive...

Αλέξανδρος Γ. Σφακιανάκης

50m

Update on Atrial Fibrillation: Review of the New AHA/ACC/HRS Treatment Guidelines Educational Objective...

Update on Atrial Fibrillation: Review of the New AHA/ACC/HRS Treatment GuidelinesEducational ObjectiveTo understand the new recommendations for atrial fibrillation treatment, including anticoagulation medication, catheter ablation, and left atrial appendage occlusion.Download MP3Subscribe to PodcastCardiologist and JAMA Deputy Editor Greg Curfman, MD, discusses the many changes in the new AHA/ACC/HRS atrial fibrillation guidelines with University of Chicago cardiologists Gaurav Upadhyay, MD, and...

Αλέξανδρος Γ. Σφακιανάκης

50m

New Approaches to Management of Depression JAMA May 24, 2019 Audio Interview 19 min 39 sec Download...

New Approaches to Management of DepressionJAMAMay 24, 2019Audio Interview 19 min 39 secDownload MP3Interview with Andrew A. Nierenberg, MD, author of Evolving Issues in the Treatment of DepressionRelatedNew Approaches to Management of Depression

Αλέξανδρος Γ. Σφακιανάκης

51m

Treating Nonmetastatic Breast Cancer in 2019 Educational Objective To understand how breast cancer is treated.

Download MP3Subscribe to PodcastBreast cancer outcomes continue to improve. Treatments for the disease are very effective and continually evolving. We spoke with Patricia A. Ganz, MD, from UCLA about what is new in breast cancer treatment.

Αλέξανδρος Γ. Σφακιανάκης

53m

If You're Trying to Lose Weight, You Need More of This Essential Nutrient, Not Less , POPSUGAR Fitness by...

If You're Trying to Lose Weight, You Need More of This Essential Nutrient, Not Less,POPSUGAR Fitness by Emilia Benton - 4m ago Preview    AUTO POST  SAVE TO EVERNOTEIf it's been a while since your last diet, you might feel inclined to shun fats in an effort to lose weight - but public opinion has shifted in recent years, and "good" fats are not only considered an important part of any meal, but also key to shedding pounds. As long as you don't overdo it, anyway.The Institute of Medicine recommends...

Αλέξανδρος Γ. Σφακιανάκης

57m

Alexandros Sfakianakis
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