Benin has adopted the WHO 2019 recommendations by integrating dolutegravir into the first‐ and second‐line treatment regimen with regular monitoring of the emergence of resistance. The standard of care document has been updated, and healthcare staff have been trained on dosage, drug interactions, and the management of adverse effects. The patient, diagnosed as HIV‐1 positive, was started on antiretroviral therapy, which had to be modified due to poor adherence. HIV‐RNA was extracted from plasma with QIAGEN RNA kit, and nested polymerase chain reaction was performed in Reference National Laboratory of Health Program Fighting Against AIDS in Benin on the polymerase gene using the Applied Biosystems HIV‐1 Genotyping Kit PR‐RT with Integrase. Drug resistance mutations and the remaining effective antiretrovirals drug were identified using Stanford University Antiretroviral‐Associated Resistance Mutation Interpretation Algorithm (https://hivdb.stanford.edu/ Version 9.8). The phylogenetic tree was constructed using SeaView with the maximum likelihood method and 1000 bootstrap iterations to identify the viral subtype along PR‐RT and integrase gene. No PI‐associated resistance mutations were observed. The NRTIs and NNRTIs associated resistance mutations were (M41 ML, D67G, S68G, K70R, M184 V, T215F, and K219E), (V179E and Y188 L), respectively. The major and accessory INSTI mutations observed were (E138 K, G140 GA, S147SG, Q148R, and N155H) and T97A, respectively. All protease inhibitors were effective against the identified HIV‐1 viral strain which was a CRF02_AG along the polymerase gene. HIV‐1 resistance genotyping can improve monitoring of the emergence of resistance in nonadherent individuals and anticipate early treatment failures in order to accelerate access to the third 95 of UNAIDS 95–95–95 target.

Current management and treatment of patients with myasthenia gravis in France: A survey of the neurologist's perspective.

Psychosocial rehabilitation applied to children

Coping with checkpoint inhibitor adverse events: Assisting cancer patients in skills development - insights from the Immuno'Act© pre-experimental pilot study.

Venous leg ulcers are the most common type of chronic wound, representing the most advanced stage of chronic venous insufficiency. Their long healing time and high recurrence rates significantly impair patients' quality of life. Management largely relies on self-management strategies, including wearing compression therapy, engaging in physical activity, and following an adapted diet. Structured and individualized educational interventions improve knowledge, foster engagement in treatment, and contribute to earlier wound healing. This article summarizes the available evidence on the role of therapeutic patient education in managing venous leg ulcers.

Mindful eating interventions target behavioral and emotional processes involved in eating, but most structured programs have been evaluated in English-speaking settings and often compared with passive controls. This randomized controlled trial assessed the effectiveness of the Mind-Eat program, a structured mindfulness-based intervention, versus treatment as usual consisting of a therapeutic patient education (TPE) program grounded in intuitive eating principles, in adults with overweight or obesity. In this single-center trial, 66 adults with overweight or obesity were randomized (1:1) after oral agreement. Of these, 56 completed baseline assessment, and 46 with baseline and at least one post-baseline assessment were included in the modified intention-to-treat analysis. The Mind-Eat group completed eight weekly experiential sessions plus one follow-up session, while the comparator group followed the department's usual TPE pathway. Assessments were conducted at baseline, post-intervention (week 8), and follow-up (week 12). The primary outcome was change in mindful eating, measured with the validated Mind-Eat Scale. Secondary outcomes included disordered and intuitive eating behaviors, psychological well-being, trait mindfulness, physical activity, and weight. Analyses used linear mixed-effects models. Significant Group × Time interactions favored the Mind-Eat group for mindful eating at week 8 (β = - 0.40, p = .002, d = - 1.32) and week 12 (β = - 0.31, p = .02, d = - 1.02). Compared with treatment as usual, Mind-Eat was also associated with greater reductions in emotional eating (and greater improvements in intuitive eating and trait mindfulness. Improvements were observed in both groups across several outcomes. No between-group differences were found for restrained eating, perceived stress, anxiety, depression, physical activity, or weight. The Mind-Eat program was associated with greater improvements in mindful eating and key eating-related behaviors, particularly emotional and external eating, than an intuitive eating-oriented TPE program delivered as treatment as usual. These findings support the added value of structured mindfulness-based experiential training in obesity care. However, they should be interpreted in light of attrition and the absence of short-term weight effects. The study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411.

Atopic dermatitis (AD) is a chronic inflammatory skin condition that significantly impacts quality of life. Therapeutic patient education (TPE) improves disease outcomes, but traditional in-person programs are often inaccessible. Video- and handout-based TPE offer more feasible alternatives, though their comparative efficacy remains unclear, particularly in diverse linguistic populations. This study compared the effectiveness of video- and handout-based TPE in pediatric AD patients and their caregivers, including both English- and Spanish-speaking participants. Interventions in English or Spanish included handouts as an active control (our standard of care) or short captioned videos addressing core AD management practices. Outcomes measured at baseline and 1-10 weeks post-intervention included Patient-Oriented Eczema Measure (POEM), Child Dermatology Life Quality Index (CDLQI), and Investigator's Global Assessment (IGA), and caregiver AD confidence. Educational accessibility and viewership were assessed at follow-up. Fifty-two dyads were randomized at an academic pediatric dermatology clinic; 22 (42%) completed both baseline and follow-up assessments. Across all participants, there were no statistically significant differences between handout and video groups in POEM, CDLQI, or IGA, educational accessibility, or caregiver confidence in AD management. English- and Spanish-speaking participants demonstrated comparable outcomes across all measures. These findings suggest that videos and handouts are both viable educational tools and support the use of well-constructed handouts as a viable, resource-conscious option, including in Spanish-speaking populations. Larger studies with improved enrollment and retention are needed to further define optimal TPE strategies.

Physical activity (PA) is recognized as a key supportive care intervention in oncology. However, encouraging patients to increase or maintain their PA level at the onset of their treatment is challenging. Therapeutic patient education may support PA during cancer treatments, but effective strategies remain to be determined. Adult patients were enrolled at the start of cancer therapy in a single-blind randomized controlled trial, in which patients and outcome assessors remained blinded to group allocation. The control group received a booklet with PA recommendations, resistance exercises, and a resistive elastic band. The experimental group received the same material plus a single 30-minute face-to-face educational session delivered by experienced physiotherapists. The primary outcome was variation in PA level between baseline and 6 months of follow-up, as measured with total global score of the International Physical Activity Questionnaire (IPAQ), analyzed on an intention-to-treat basis. Secondary outcomes included fatigue, health-related quality of life, and physical function. Ninety-eight patients were included. At 6 months, the IPAQ total global scores were maintained in both groups, with no significant between-group differences. There were no significant between-group differences in secondary outcomes, except for the IPAQ Transport subscale (P = .026) favoring the control group. The addition of a single-session educational intervention beyond the provision of educational material at the onset of cancer therapy did not significantly increase PA. However, PA levels were maintained in both groups. More iterative, tailored, or group-based interventions may be required to achieve measurable behavioral changes in PA.

Development of a therapeutic patient education curriculum for healthcare professionals to improve diabetes care in the Eastern Mediterranean region.

Paediatric feeding disorders (PFDs) are common but often underrecognised in primary care. Families frequently face long diagnostic delays and fragmented management. Therapeutic patient education (TPE) programmes exist in hospital settings but remain rare in community care. To design and implement a structured, multidisciplinary TPE programme for children with PFD and their parents, adapted to a primary care context. The pilot programme was launched in February 2025 within the Maison de Santé Pluriprofessionnelle Universitaire Corneille (MSPU; Hauts-de-France). It was developed by a primary care team in partnership with the regional CPTS (Communauté Professionnelle Territoriale de Santé), which will provide ongoing financial support to extend the initiative. This programme consists of five 2-hour workshops involving one child (aged 3-8 years) and at least one parent per session. Each group includes six children and 14 parents, supervised by three health professionals - always including a speech therapist - trained in TPE and non-violent communication. Sessions cover eating mechanisms, posture, nutrition, sensory exploration, and emotional regulation. The first cycle involved six children and their families. Early feedback indicates high engagement, improved parental confidence, and observed progress in children's mealtime comfort. Twenty-four additional families are already registered and awaiting the next series of workshops planned for late 2025. This first TPE programme for PFD implemented in primary care demonstrates feasibility, strong acceptability, and interprofessional collaboration. It offers a promising model for community-based management of complex paediatric feeding issues.

Type1 diabetes in children is an increasingly condition, even in young children. Medical care combines insulin therapy, a balanced diet meeting nutritional children's needs, physical activity and therapeutic education of patients and caregivers. Blood glucose monitoring can be performed using capillary blood tests or use of continuous monitoring glucose sensors help providing comfort and accuracy. Insulin treatment follows a basal bolus regiment which can be delivered by insulin pen or insulin pump. Functional insulin therapy is often proposed and consists in adjusting insulin dose according to the amount of carbohydrates consumed. Hybrid closed-loop system incorporates an algorithm that adapts insulin doses delivered by the pump based on the patient's blood glucose level. It helps glycemic control and reducing diabetes burden. Preclinical diagnosis of diabetes could help preventing diabetic ketoacidosis, improving metabolic control and proposing treatments that can delay appearance of diabetes symptoms and need of insulin. It represents a major challenge for following years.

BackgroundHeart failure (HF) represents a major public health challenge worldwide, with particularly high morbidity and mortality in resource-limited settings. Despite its growing burden in sub-Saharan Africa, comprehensive epidemiological data from Madagascar remain scarce. This study aimed to describe the epidemiological, clinical, paraclinical, therapeutic, and prognostic profile of patients hospitalized for heart failure at the Centre Hospitalier Universitaire Morafeno Toamasina (University Hospital Center Morafeno Toamasina) (CHUMT), and to identify independent factors associated with prolonged hospitalization, rehospitalization, and in-hospital mortality.MethodsWe conducted a retrospective, cross-sectional, descriptive study in the cardiology department of CHUMT from January 1, 2021, to December 31, 2023. All patients hospitalized for echocardiographically confirmed heart failure were included. Data were collected from medical records using standardized forms. Binary logistic regression analyses (univariate followed by multivariate) were performed using Stata version 13 (StataCorp, College Station, USA) to identify independent factors associated with prolonged hospitalization (≥7 days), rehospitalization during the study period, and in-hospital mortality. Statistical significance was set at p<0.05.ResultsA total of 168 patients were included over the 36-month study period. The mean age was 54 ± 14 years (range: 18-89 years), with a sex ratio of 0.97 (50.6% female). The most prevalent cardiovascular risk factors were hypertension (n=86; 51.2%), overweight (n=46; 27.4%), and diabetes mellitus (n=37; 22.0%). Global heart failure was the predominant clinical form (n=127; 75.6%). Ischemic cardiomyopathy was the leading etiology (n=46; 27.4%), followed by hypertensive heart disease (n=39; 23.2%). Heart failure with reduced ejection fraction (HFrEF, left ventricular ejection fraction (LVEF) <40%) accounted for 53.6% (n=90) of cases. Clinical outcomes included favorable discharge in 81.5% (n=137) of cases, in-hospital mortality of 9.5% (n=16), and a 6-month rehospitalization rate of 41.7% (n=70). In multivariate analysis, right ventricular systolic dysfunction was the only independent factor associated with prolonged hospitalization (adjusted OR = 6.1; 95% CI: 1.5-23.5; p = 0.009). Atrial fibrillation (adjusted OR = 3.4; 95% CI: 1.3-29.3; p = 0.036) and intraventricular conduction disorders (adjusted OR = 2.3; 95% CI: 1.4-36.6; p = 0.013) were independently associated with rehospitalization. No factor reached statistical significance for in-hospital mortality in multivariate analysis.ConclusionHeart failure at CHUMT affects relatively young patients, predominantly presenting with global heart failure and primarily attributable to ischemic and hypertensive etiologies. Right ventricular systolic dysfunction, atrial fibrillation, and intraventricular conduction disorders are key independent prognostic factors. Strengthening cardiovascular prevention strategies, improving early diagnosis, and implementing structured therapeutic patient education programs are essential to reduce mortality, hospitalization duration, and readmission rates in this resource-limited setting.

Background: Therapeutic Patient Education (TPE) has increasingly been integrated into maternal healthcare to support women during pregnancy and the postpartum period. By enhancing self-management skills and informed health behaviors, TPE may influence maternal knowledge, perceived health outcomes, and satisfaction with care. Objectives: This study aimed to examine the association between exposure to Therapeutic Patient Education (TPE) and postnatal health practices and perceived outcomes among postpartum women. Specifically, it assessed the relationship between TPE and postnatal knowledge, perceived reduction of postpartum complications, and satisfaction with postnatal care. Methods: A quantitative, descriptive, cross-sectional study was conducted among 250 postpartum women followed in several public and private hospitals in Mount Lebanon, Lebanon. Data were collected using a structured questionnaire based on a five-point Likert scale. Exposure to TPE was assessed through self-reported participation in educational sessions during pregnancy and hospitalization. Statistical analyses included descriptive statistics, Cronbach’s alpha to assess internal consistency, Pearson correlation coefficients, analysis of variance, and simple linear regression models. Results: Exposure to TPE was reported by 70% of participants during pregnancy and by 76% during hospitalization. Higher TPE scores were significantly associated with greater postnatal knowledge (R² = 0.505, p &lt; 0.05), a perceived reduction in postpartum complications (R² = 0.469, p &lt; 0.05), and higher satisfaction with postnatal care (R² = 0.552, p &lt; 0.05). Despite these associations, maternal rehospitalization within 40 days postpartum (5.6%) and neonatal hospitalization within the first six months of life (5.4%) remained relatively frequent, suggesting potential gaps in post-discharge follow-up. Conclusion: In this sample of women followed in public and private hospitals in Mount Lebanon, exposure to Therapeutic Patient Education was strongly associated with improved perceived knowledge, a perceived reduction in postpartum complications, and higher satisfaction with postnatal care. However, inconsistent implementation and limited postnatal follow-up may constrain its overall effectiveness. Expanding standardized and continuous TPE beyond hospital discharge may help improve maternal and neonatal health outcomes in Lebanon.

Bipolar disorder (BD) is a chronic psychiatric illness associated with high rates of medical comorbidities, among which metabolic syndrome (MetS) is particularly prevalent and consequential. Affecting nearly half of individuals with BD, MetS compounds the risk of cardiovascular disease, type 2 diabetes, and premature mortality, while also undermining psychiatric stability and cognitive functioning. Despite these outcomes, metabolic health remains underrecognized and undertreated in psychiatric care. This narrative review aims to examine the bidirectional relationship between BD and metabolic syndrome and to highlight multidisciplinary strategies for metabolic monitoring and clinical management in this population. A targeted literature search was conducted using PubMed (2000-2025), covering studies on the epidemiology, behavioral and biological mechanisms, pharmacologic and lifestyle interventions, and clinical care integration related to BD and MetS. The review followed established quality guidance for narrative synthesis and was structured using the Population-Concept-Context framework to improve transparency in the selection and synthesis of the literature. The comorbidity between BD and MetS is shaped by multiple interacting factors, including shared behavioral risk factors, inflammatory pathways, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and the metabolic effects of psychotropic medications. While pharmacological treatment remains essential for mood stabilization, systematic metabolic monitoring is crucial to mitigate treatment-related risks. Evidence supports the central role of lifestyle interventions, including nutritional strategies and physical activity in reducing cardiometabolic risk. Emerging therapeutic approaches such as GLP-1 receptor agonists and ketogenic metabolic therapy show potential benefits but require careful clinical integration. In selected individuals with severe or refractory obesity, bariatric surgery may be considered. Therapeutic patient education (TPE) represents the cornerstone of care by supporting self-management, treatment adherence, and shared decision-making. Addressing the dual burden of BD and MetS requires a multidisciplinary and patient-centered approach integrating metabolic monitoring, lifestyle interventions, pharmacological strategies, and therapeutic patient education. Strengthening collaboration between psychiatry, primary care, and metabolic specialists is essential to reduce cardiometabolic risk and improve long-term health outcomes in this vulnerable population.

Introduction: Self-efficacy is reported as the factor that most influences hemodialysis patient adherence. Interventions to improve self-efficacy have been developed, including through education. The education provided must be structured and include psychosocial aspects to increase self-efficacy, one of the interventions that can be done is Therapeutic Patient Education (TPE). Objectives: This study aims to determine the effectiveness of therapeutic patient education in Increasing the self-efficacy of patients with chronic kidney disease who are undergoing hemodialysis. Methods: This type of research is a Quasy-Experiment with a pre-test and post-test without a control group approach. 63 respondents were involved in the study. The inclusion criteria in this study were patients who regularly attended hemodialysis sessions, aged 18-65 years, and underwent hemodialysis for more than 3 months, while the exclusion criteria included patients who experienced intradialytic complications and patients who were not willing to become respondents. Data collection used the General Self-Efficacy Scale. Bivariate analysis used paired t-test. Results: Bivariate analysis using the paired t-test found that there was a difference in mean self-efficacy between before (mean 26.70, SD 5.732) and after the Therapeutic Patient Education (TPE) intervention (mean 33.24, SD 4.102, t = 16.393, df 62). The value of p=0.000 (&lt;0.05) indicates that the Therapeutic Patient Education (TPE) intervention is effective in increasing the self-efficacy of chronic kidney disease patients undergoing hemodialysis. Conclusions: Therapeutic Patient Education (TPE) effectively increases the self-efficacy of chronic kidney disease patients undergoing hemodialysis.

OBJECTIVE: To describe the core elements of therapeutic patient education programs for adults with subacute and chronic MSK conditions. DESIGN: Scoping review to identify specific components of therapeutic patient education programs. LITERATURE SEARCH: Five databases were searched from 2005 to 2025. STUDY SELECTION CRITERIA: Randomized clinical trials evaluating any types of therapeutic patient education in adults with MSK conditions, compared to rehabilitation interventions. DATA SYNTHESIS: A descriptive synthesis was conducted based on 3 core elements of therapeutic patient education: the themes (activity modification, behavioral approaches, exercise intensity and pain response, pain biology, pain self-management, pathoanatomical/diagnosis, and posture), their delivery methods (contextual examples, education sessions, group interaction, personalized sessions, self-reflection, video, and written materials), and the intervention parameters (duration/session, number of sessions, number of sessions/week, and duration of follow-up). RESULTS: Seventy therapeutic patient education programs were identified across 62 randomized clinical trials. The most frequently addressed themes were pain biology and pathoanatomical/diagnostic. Education was most frequently delivered through education sessions with verbal explanation, personalized sessions, and written materials. Intervention parameters varied depending on whether the education program was implemented as a stand-alone intervention or combined with other approaches. The general trend observed was 3 to 4 sessions of 40 to 60 minutes over a period of 1 month and an average of 2.5 topics covered. CONCLUSION: Despite variability in program components, our review provides a foundation for clinicians and underscores the need for future research to identify key elements of therapeutic patient education. J Orthop Sports Phys Ther 2026;56(4):248-260. Epub 6 March 2026. doi:10.2519/jospt.2026.13784.

Type 2 diabetes is now recognised as a dynamic condition that can sometimes go into remission. From this perspective, exercise training is a key factor in slowing the progression of the disease and supporting this remission process. The beneficial effects of exercise are attributable to the essential role of muscle as an endocrine organ and the genuine metabolic dialogue it engages in with other organs. In this regard, it is imperative to provide patients with support as they undergo physical transformation, fostering a sense of purpose and fulfilment in this process. Alliance, listening to patients' experiences and personalised teaching are at the heart of therapeutic patient education, which can promote potential remission of diabetes, while giving even greater meaning to the commitment of healthcare professionals.

This study aimed to assess determinants of health-related quality of life among patients with rheumatoid arthritis in northwest Ethiopia in 2025. A multi-center cross-sectional design was employed. A systematic random sampling technique was utilized to collect data. Face-to-face interviews with respondents from selected hospitals were conducted to gather data. The analysis was performed on a sample of 422 rheumatoid arthritis patients randomly selected from a total of 5280 across six comprehensive specialized hospitals in northwestern Ethiopia. Multiple linear regression was used to identify associated factors. Statistical significance was set at P-value < 0.05. The summaries of the physical and mental components had mean scores of 30.7 (SD, 11.35) and 43.5 (SD, 12.01), respectively. The physical component summary was negatively associated with being uneducated (β = - 0.14, 95% CI (-4.03,-0.04)), high disease activity (β =-0.63, 95% CI (-20.70,-11.95)), and unavailability of medication (β = - 0.24, 95% CI (-5.23,-1.45)). Being employed was positively associated (β = 0.12, 95% CI (0.08, 4.81)). The mental component summary was negatively associated with obesity (β = -0.18, 95% CI (-9.62,-0.45)), high disease activity (β = -0.55, 95% CI (-20.45,-9.95)), marital status (β =-0.21, 95% CI (-5.79, -1.12)), and unavailability of medication (β = -0.12, 95% CI (-6.31,-1.54)). Overall, the study revealed that health-related quality of life was poor. Rheumatoid arthritis patients' physical health-related quality of life was more affected than their mental quality of life. Factors such as being single, disease activity, medication availability, and disease duration influence health-related quality of life. Prioritizing therapeutic education and medication availability for patients with long-standing disease and high disease activity is crucial to improving health-related quality of life. Key Points • Poor health-related quality of life: Patients with rheumatoid arthritis (RA) in North West Ethiopia experience significantly low health-related quality of life, particularly in physical health. • Determinants identified: Key factors affecting quality of life include marital status, disease activity, obesity, medication availability, and duration of illness, with single and obese patients particularly affected. • Need for education and access: Emphasizing therapeutic education and ensuring medication availability for patients with prolonged disease duration and high disease activity is vital for improving health outcomes. • Healthcare recommendations: Targeted public health interventions should address socio-demographic influences and enhance health literacy among RA patients to improve their quality of life.

Tuberculosis is a major cause of morbidity and mortality worldwide, affecting mainly low- and middle-income countries, but persisting in vulnerable populations in high-income countries. The effectiveness of tuberculosis treatments depends on strict adherence, which is often compromised by the length of the protocols, adverse drug effects, and unfavorable psychosocial determinants. Patient therapeutic education is a structured, multidisciplinary strategy aimed at strengthening the knowledge, self-management skills, and autonomy of patients with tuberculosis, whether they have latent tuberculosis infection or active tuberculosis disease. It is complementary, improving treatment adherence and clinical outcomes and helping to strengthen the fight against tuberculosis.

In type 2 diabetes mellitus, the prevalence at diagnosis, incidence, and remission of erectile dysfunction are unknown. We evaluated the prevalence, incidence, remission, and predictors of erectile dysfunction in newly diagnosed and uncomplicated type 2 diabetic men. We consecutively enrolled 549 diabetic men without complications. Erectile dysfunction was diagnosed using the International Index for Erectile Function 5 questionnaire. Patients were followed up for 64.2±22.1 months. At baseline, 133 patients had erectile dysfunction and 416 patients did not. The prevalence of erectile dysfunction was 24.2%. Among the 416 patients without erectile dysfunction at baseline, 67 (16.1%) patients developed erectile dysfunction at follow-up, with an erectile dysfunction incidence of 2.3%/y. Among the 133 patients with erectile dysfunction at baseline, 27 (20.3%) patients had remission at follow-up, with an erectile dysfunction remission rate of 0.9%/y. Multivariate analysis showed that age>60 years, total testosterone levels of<2.8 ng/mL and uric acid levels of>6 mg/dL were predictors of erectile dysfunction at diagnosis. Predictors of erectile dysfunction incidence were age>60 years, smoking and low total testosterone levels, whereas total testosterone levels of>2.8 ng/mL predicted erectile dysfunction remission. No significant association between therapeutic patient education and erectile dysfunction was observed. In conclusion, one quarter of men with newly diagnosed and uncomplicated type 2 diabetes has erectile dysfunction at diagnosis. The incidence of erectile dysfunction was 2.3%/y, while remission was 0.9%/y. Older age, low total testosterone levels, and hyperuricemia were associated with erectile dysfunction at diabetes diagnosis, while older age, smoking, and total testosterone levels were the longitudinal predictors of erectile dysfunction.