A review of MR spectroscopy studies of pediatric bipolar disorder.

Pediatric bipolar disorder is a severe mental illness whose pathophysiology is poorly understood and for which there is an urgent need for improved diagnosis and treatment. MR spectroscopy is a neuroimaging method capable of in vivo measurement of neurochemicals relevant to bipolar disorder neurobiology. MR spectroscopy studies of adult bipolar disorder provide consistent evidence for alterations in the glutamate system and mitochondrial function. In bipolar disorder, these 2 phenomena may be linked because 85% of glucose in the brain is consumed by glutamatergic neurotransmission and the conversion of glutamate to glutamine. The purpose of this article is to review the MR spectroscopic imaging literature in pediatric bipolar disorder, at-risk samples, and severe mood dysregulation, with a focus on the published findings that are relevant to glutamatergic and mitochondrial functioning. Potential directions for future MR spectroscopy studies of the glutamate system and mitochondrial dysfunction in pediatric bipolar disorder are discussed.

Demographic characteristics of US medical school admission committees.

CONTEXT: Although concerns continue to be raised about the diversity of the US physician workforce, there has never been a nationwide survey of both the sex and underrepresented minority (URM) composition of medical school admission committees. OBJECTIVE: To document US medical school admission committee membership in several demographic domains, including sex and URM (African American, Mexican American, mainland Puerto Rican, Native American, Native Hawaiian, and Native Alaskan) status. DESIGN: Mailed survey. SETTING AND PARTICIPANTS: Deans or directors of admission at 85 US medical schools that were members of the Association of American Medical Colleges (response rate, 70%). MAIN OUTCOME MEASURES: Prevalence of 1999-2000 school-year committee members in demographic categories, such as sex, URM status, physician or medical student status; compensation status. RESULTS: The overall ratio of men to women on admission committees was 1.77 to 1. On average, 16% of committee members were from URM groups. Physicians with URM status comprised 8% of committee membership; 51% of committees had 1 or 0 URM physicians. Seventy-four percent of committees had at least 1 medical student; medical students comprised 15% of total membership. Ninety-one percent of committees operated on a volunteer basis. CONCLUSION: Although representation of women and persons with URM status on medical school admission committees has improved since 1972, URM membership, in particular, remains low. JAMA. 2000;284:1111-1113