Telemedicine for Facio-Scapulo-Humeral Muscular Dystrophy: A multidisciplinary approach to improve quality of life and reduce hospitalization rate?

Background

Facio-Scapulo-Humeral Muscular Dystrophy (FSHD) is an autosomal dominant inherited disorder characterized by a variable and asymmetric involvement of facial, trunk, upper and lower extremity muscles. Although respiratory weakness is a relatively unknown feature of FSHD, it is not rare. Telemedicine has been used in a variety of health care fields, but only recently, with the advent of sophisticated technology, its interest among health professionals became evident, even in such diseases.

Validity and reliability of the Disabilities of Arm,Shoulder, and Hand scale in dental students: A transnational study

This study aimed to evaluate the validity and reliability of the Disabilities of Arm, Shoulder, and Hand (DASH) scale in Brazilian and American dental students and assess the influence of demographic variables on disability in them. A cross-sectional observational study was conducted with a nonprobabilistic sample. The sample was composed of students of both genders from the School of Dentistry of Araraquara, State University of São Paulo (UNESP) (n = 288), and students from Stony Brook University, New York, NY, USA (n = 149). The disabilities of the upper limbs were estimated using the DASH scale. The samples were characterized by collecting information on gender, academic year, and sports and work activities. The refined bifactorial model presented goodness-of-fit indices for both countries. There was a significant effect of the variables gender and academic year for the Brazilian sample and the variable sports practices for the American sample. The refined bifactorial model was valid and reliable for the Brazilian and American populations. In this model, the removal of item 17 for the Brazilian sample and items 3, 13, and 23 for the American sample was necessary. Demographic variables such as gender, academic year, and sports practice contributed significantly to the level of disability in the study populations.     

Helping Smokers Quit: The Smoking Cessation Leadership Center Engages Behavioral Health by Challenging Old Myths and Traditions

Smoking is much more common among persons with behavioral health conditions (mental illnesses and/or substance use disorders). Persons with these disorders are more likely to die from smoking-related causes than any other reason. Studies have shown that stopping smoking can improve mental health function, as well as improve outcomes for substance use disorders. Yet, for a variety of reasons, smoking cessation has not been integrated into the treatment of behavioral health conditions, and in many instances tobacco use was not only condoned but encouraged. Beginning in 2007, the Smoking Cessation Leadership Center (SCLC) began engaging relevant agencies in an attempt to stimulate more vigorous smoking cessation activities. Partners included the federal Substance Abuse and Mental Health Services Administration, advocacy organizations such as the National Alliance on Mental Illness and Community Anti-Drug Coalitions of America, and clinical groups such as the American Psychiatric Nurses Association, the American Psychiatric Association, American Psychological Association, National Council on Behavioral Health, and National Association of State Mental Health Program Directors. A signature program featured 16 individual state summits involving agencies and groups from multiple sectors, all aiming to lower smoking rates in behavioral health populations. These activities mark an evolving culture change within behavioral health.     

Pharmacists' interventions to reduce sedative/hypnotic use for insomnia in hospitalized patients

Background

Hospitalization can contribute to insomnia in many patients and is usually treated symptomatically. However, sedative/hypnotic misuse is associated with complications in this population, especially in the elderly. Such complications include dizziness, falls and over-sedation. Due to the implicit dangers, widespread use of these drugs for insomnia, particularly in older patients, has been discouraged by many hospitals. The aim of this study was to review and evaluate prescribing patterns and to optimize the use of the sedative/hypnotic agents through daily pharmacy interventions at a community hospital.

Responses to warnings about the impact of eating disorders on fertility: a qualitative study

Eating disorders (EDs) have often been discussed as a risk to reproductive health. But existing research is quantitative in nature, paying no attention to issues of patient experience. In discussing data from 24 semi‐structured interviews, this article draws on sociological approaches to medical ‘risk’ and feminist approaches to EDs to explore how women with experience of an ED responded to fertility warnings within treatment contexts. In doing so, it is suggested that responses to fertility warnings offer unique insight into the potentially damaging limitations of biomedical approaches to eating problems and their focus on EDs as individual ‘pathologies’ (rather than culturally embedded expressions of gendered embodiment). At best warnings are seen as making problematic assumptions about the aspirations of female patients, which may curtail feelings of agency and choice. At worst, they may push women further into destructive bodily and eating practices, and silence the distress that may be articulated by an ED.     

Efficacy and safety of plecanatide in treating constipation predominant irritable bowel syndrome

Introduction: Uroguanylin interacting with intestinal Guanylate Cyclase C (GC-C) receptors plays an important role in gastrointestinal fluid and electrolyte homeostasis. Plecanatide is the first uroguanylin analog that stimulates GC-C receptors on gastrointestinal mucosa with pH-sensitive receptor binding. Binding to the GC-C receptor activates intracellular conversion of GTP to cGMP resulting in the stimulation of intestinal fluid secretion.

Areas covered: Herein, all published research regarding the development of and clinical experience with plecanatide is reviewed. Clinical study results in patients with Chronic Idiopathic Constipation (CIC) and Irritable Bowel Syndrome with Constipation (IBS-C) are also reviewed. Success in the treatment of CIC and IBS-C is supported by beneficial effects on stool viscosity, Complete Spontaneous Bowel Movements and visceral sensation. Finally, the discussion within focuses on the importance of plecanatide in understanding the physiology of uroguanylin, the pathophysiology of IBS-C and the potential for development of uroguanylin and guanylin analogs.

Expert opinion: Given this broad spectrum of potential activity for GC-C agonists, it would not be surprising to see that the use of agents such as plecanatide in new areas grow to a level even greater than the use for the present CIC and IBS-C indications.