Complex Congenital Heart Disease and Congenital Uterine Anomalies Impacting Pregnancy Outcomes.

Complex congenital heart disease is often accompanied by extracardiac manifestations; , the significance of genitourinary involvement remains unclear. We present 3 patients with palliated complex congenital heart disease and with pregnancies complicated by premature delivery who were found to have congenital uterine anomalies that may have contributed to their obstetrical complications.

Clinicians' Guide to Cannabidiol and Hemp Oils.

Cannabidiol (CBD) oils are low tetrahydrocannabinol products derived from Cannabis sativa that have become very popular over the past few years. Patients report relief for a variety of conditions, particularly pain, without the intoxicating adverse effects of medical marijuana. In June 2018, the first CBD-based drug, Epidiolex, was approved by the US Food and Drug Administration for treatment of rare, severe epilepsy, further putting the spotlight on CBD and hemp oils. There is a growing body of preclinical and clinical evidence to support use of CBD oils for many conditions, suggesting its potential role as another option for treating challenging chronic pain or opioid addiction. Care must be taken when directing patients toward CBD products because there is little regulation, and studies have found inaccurate labeling of CBD and tetrahydrocannabinol quantities. This article provides an overview of the scientific work on cannabinoids, CBD, and hemp oil and the distinction between marijuana, hemp, and the different components of CBD and hemp oil products. We summarize the current legal status of CBD and hemp oils in the United States and provide a guide to identifying higher-quality products so that clinicians can advise their patients on the safest and most evidence-based formulations. This review is based on a PubMed search using the terms CBD, cannabidiol, hemp oil, and medical marijuana. Articles were screened for relevance, and those with the most up-to-date information were selected for inclusion.

"There Is Always a Teacher Among Them": Reflections From an American Medical Student on Time Spent With Medical Providers in the United States, China, and Vietnam.

There is a famous Chinese saying by Confucius that goes "With three men walking, there is always a teacher among them." In this narrative essay, I recount the story of how curiosity led me to find lessons about medicine from research on complementary and alternative medicine and medical service experiences in the "three men walking" of China, Vietnam, and the United States. As we visit the many teachers I had along the way, we will draw out various lessons from each experience and reflect on the value in experiencing cross-cultural medicine as a medical provider-in-training, with the hope that it will inspire other aspiring healers to cultivate their own curiosity. Travel with me from a bench outside a traditional Chinese medicine clinic in Beijing to orphanages in Vietnam and unearth what the "three men walking" of the United States, China, and Vietnam have to teach us.