A systematic review of interventions to improve knowledge and self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis

This systematic review aimed to determine the effectiveness of interventions for improving knowledge and/or self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis (RA). We searched four databases (MEDLINE, CINAHL, Cochrane Trials, PsycINFO) using a comprehensive search strategy. Studies were eligible if they were prospective, published in English from 2004 to 2015, included participants with RA and tested an intervention designed to improve knowledge and/or self-management skills relating to family planning, pregnancy or breastfeeding. As no studies met the latter criterion, the search strategy was expanded to include all prospective studies evaluating RA educational and/or self-management interventions. Data on study characteristics, participant characteristics and programme content were extracted to summarise the evidence base for interventions to support people with RA during their reproductive years. Expanded literature searches identified 2290 papers, of which 68 were eligible. Of these, nine papers (13 %) specifically excluded pregnant women/breastfeeding mothers or recruited only older people.Only one study (1 %) explicitly evaluated pregnancy-focused education via a motherhood decision aid, while eight studies (12 %) incorporated relevant (albeit minor) components within broader RA educational or self-management interventions. Of these, three studies provided methotrexate education in relation to conception/pregnancy/breastfeeding; three incorporated discussions on RA and relationships, impact of RA on the family or sexual advice; one provided information regarding contraception and fertility; and one issued a warning regarding use of biologic therapy in pregnancy/breastfeeding. In conclusion, information regarding family planning, pregnancy or breastfeeding represents a negligible part of published RA educational interventions, with scope to develop targeted resources

Retweeting: its linguistic and epistemic value

This paper analyses the communicative and epistemic value of retweeting (and more generally of reposting content on social media). Against a naïve view, it argues that retweets are not acts of endorsement, motivating this diagnosis with linguistic data. Retweeting is instead modelled as a peculiar form of quotation, in which the reported content is indicated rather than reproduced. A relevance-theoretic account of the communicative import of retweeting is then developed, to spell out the complex mechanisms by which retweets achieve their communicative goals. The last section outlines the epistemic threats posed by the increasing prevalence of retweeting on social media, linking them to the low reputational, cognitive, and practical costs linked to this emerging form of communication

Spotlight on adapalene.

BACKGROUND: In the field of dermatology, topical retinoids represent a mainstay in acne treatment. Adapalene is a naphthoic acid derivative showing some pharmacological activities similar to the regular retinoids. The drug is used singly or in combination for treating acne and a few other miscellaneous skin disorders. OBJECTIVE: To critically review the pharmacokinetic, pharmacologic aspects and clinical benefits and adverse effects associated with topical adapalene. METHOD: A systematic literature review was conducted primarily based on PubMed citations. RESULTS/CONCLUSIONS: Adapalene shares some biological activities in common with retinoic acid. However, it exhibits distinct physicochemical and binding properties for selective retinoic acid receptors. In acne, adapalene is expected to reduce comedogenesis, expel mature comedones and exert some anti-inflammatory effects. The drug is effective as monotherapy in mild comedonal acne and in combination with benzoyl peroxide for mild-to-moderate inflammatory acne. The safety profile of adapalene is good. Indeed, only discrete to moderate adverse events including erytheme, xerosis, itching and stinging may develop during the early treatment phase. Clinical experience has established that adapalene represents a valuable addition to the other current treatments for acne

Robot-assisted simple prostatectomy

Simple prostatectomy (SP) is a viable option for surgical management of lower urinary tract symptoms (LUTS) in men with large prostatic adenoma. Robotic simple prostatectomy (RASP) has been popularized in the last years and combines the benefits of minimally-invasive surgery with the efficacy of conventional simple prostatectomy. In this chapter we present the different RASP techniques described in current literature (transvesical and transcapsular approach, with intra and extraperitoneal access). Moreover, we discuss the perioperative and functional outcomes of RASP, also in comparison with laparoscopic SP and Holmium laser enucleation (Holep)