Update on current contraceptive options: A case-based discussion of efficacy, eligibility, and use.

With high rates of unintended pregnancy in the United States, it is crucial for clinicians to be well-informed about the full spectrum of contraceptive options to improve reproductive autonomy. We review new contraceptive options including a nonhormonal intravaginal gel, hormonal contraceptives in the form of new pills, patches, and vaginal rings, and combined hormonal contraceptives that contain new estrogens as alternatives to ethinyl estradiol. We review updated prescribing methods for several established hormonal contraceptives such as depot medroxyprogesterone acetate, which is now available for subcutaneous self-injection. Additional choices of available contraceptive methods have important clinical implications that may remove unnecessary barriers to contraceptive use.

A Rare Triad: Hypercalcemia-Induced Necrotizing Pancreatitis Presenting as Severe Diabetic Ketoacidosis.

Primary hyperparathyroidism (PHPT) typically occurs in persons above 45 years, with a female predominance. PHPT induces a state of hypercalcemia, but acute pancreatitis is a rare sequelae of this hypercalcemia. We report a case of a 31-year-old man with no known medical history who presented in diabetic ketoacidosis with electrolyte abnormalities. His clinical course progressed to multi-organ dysfunction despite correction of metabolic derangements. Further workup led to the discovery of the uncommon triad by which previously undiagnosed PHPT precipitated severe diabetic ketoacidosis.