Nurse Practitioners' Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia.

BACKGROUND: In the United States, fibromyalgia affects 2%-5% of the adult population, rendering it the most common chronic, widespread pain condition. The American College of Rheumatology has published diagnostic criteria for fibromyalgia, with the latest version in 2010. PURPOSE: The purpose of this study was to evaluate nurse practitioners' education and awareness of fibromyalgia and to evaluate nurse practitioners' practices for the management of fibromyalgia. METHODS: Sixty-six nurse practitioners voluntarily completed an online survey regarding their education, diagnosis, and treatment options for patients with fibromyalgia. RESULTS: The majority of participants reported that they always or occasionally had difficulty diagnosing fibromyalgia and worried about labeling their patients as having fibromyalgia. The most commonly used agents were nonsteroidal anti-inflammatory drugs (70%), serotonin norepinephrine reuptake inhibitors (61%), selective serotonin reuptake inhibitors (51%), and muscle relaxants (44%). Nondrug therapies included exercise (88%), cognitive behavior therapy (58%), and nutrition (56%). CONCLUSION: Further education is needed for nurse practitioners to increase confidence in diagnosing and managing fibromyalgia.

Microbiota and pelvic inflammatory disease.

Female genital tract microbiota play a crucial role in maintaining health. Disequilibrium of the microbiota has been associated with increased risk of pelvic infections. In recent years, culture-independent molecular techniques have expanded understanding of the composition of genital microbiota and the dynamic nature of the microbiota. There is evidence that upper genital tract may not be sterile and may harbor microflora in the physiologic state. The isolation of bacterial vaginosis-associated organisms in women with genital infections establishes a link between pelvic infections and abnormal vaginal flora. With the understanding of the composition of the microbiota in healthy and diseased states, the next logical step is to identify the function of the newly identified microbes. This knowledge will further expand our understanding of the causation of pelvic infections, which may lead to more effective prevention and treatment strategies.

Asian immigrants to the United States are less likely to donate cryopreserved embryos for research use.

OBJECTIVE: To determine whether there are ethnic differences in the proportion of IVF patients donating excess cryopreserved embryos for use in research. DESIGN: Retrospective. SETTING: University clinic. PATIENT(S): Four hundred consecutive patients undergoing IVF. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Embryo disposition plan reported on the cryopreservation consent form (disposal, donation for research, or donation for therapeutic use). RESULT(S): Compared with Europeans or Asians born in the U.S., Asians born outside the U.S. were less likely to opt to donate excess embryos. Research donation was highly associated with interest in participation in clinical research. CONCLUSION(S): Decreased donation of excess embryos for research among Asians born outside the U.S. may relate to religious, sociocultural, language, or other undescribed factors. Targeted educational strategies may be critical to the development of a diverse pool of embryos available for research.