Telehealth transition in a comprehensive care unit for eating disorders: Challenges and long-term benefits.

The 2019 novel coronavirus disease (COVID-19) pandemic has forced many eating disorder medical stabilization units to consider adjustments that uphold both the quality of care delivered to patients while also observing social distancing public health directives for patients and staff. To date, inpatient facilities for eating disorders (both medical stabilization units and higher level of care facilities) have not needed to consider how to translate services to electronic platforms, given that most of these programs have in-person staff. We outline our transition to telehealth broadly, emphasizing some unexpected benefits of using telehealth services that we plan on integrating into our work-flow post COVID-19.

CAPs and College.

Time flies. Young people grow up and are off to college. It's exciting.

The Role of Higher Levels of Care for Eating Disorders in Youth.

Many eating disorder patients are successfully treated in outpatient settings. Family-based treatment allows youth to recover at home. Higher levels of care may be necessary for medical or psychiatric stabilization, or to provide added structure.

Eating Disorders in Transitional Age Youth.

Eating disorders are common in children and adolescents, and may continue, resurface, or present anew in young people making the transition to adulthood. This may affect the young person's academic or occupational trajectory, and patients and parents/families need to recognize the supports that may be necessary to allow the emerging adult to be successful in navigating independent living, increased work or educational autonomy, and adult relationships. Colleges and universities are able to provide some support, but patients, families, and clinicians must be aware of limitations and must be thoughtful about options available to promote successful transition wherever possible.

Transitional Age Youth and College Mental Health.

Transitional age youth with a history of mood disorders, such as major depressive disorder, are uniquely vulnerable to clinical destabilization and relapse in the context of life transition. Moving from a structured adolescence to a more independent and potentially more demanding young adult life can result in worsening symptoms and barriers to effective help-seeking. Transitional age youth newly diagnosed are exposed to their first course of treatment of a potentially chronic condition.

Applying family-based treatment (FBT) to three clinical presentations of avoidant/restrictive food intake disorder: Similarities and differences from FBT for anorexia nervosa.

Objective: This article uses three brief case reports to illustrate how family-based treatment (FBT) can be used to treat pre-adolescents with avoidant/restrictive food intake disorder (ARFID).

Method: We present case material illustrating how FBT can be used in three different clinical presentations of ARFID: (1) low appetite and lack of interest; (2) sensory sensitive eaters; and (3) fear of aversive consequences eaters-all without shape or weight concerns.

Results: This case material illustrates that the main principles of FBT-agnosticism as to the cause of the illness, externalization, emphasizing the seriousness of ARFID, parental empowerment, behavioral consultation, and practical behavioral focus-are applicable for a range of ARFID clinical presentations.

Teaching a Systematic Approach for Transitioning Patients to College: An Interactive Continuing Medical Education Program.

Objective: The purpose of this article is to determine the effectiveness of a hands-on continuing education program for practicing child and adolescent psychiatrists (CAPs) with a focus on best practices in transitioning psychiatric patients to college. The plan was to build on the unique knowledge and skill set of CAPs, use audience and facilitator feedback from prior programs to inform program content, structure, and format, and incorporate findings from the evolving literature.

Methods: A 3-h interactive workshop was designed with an emphasis on audience participation.

A Model CSMH Curriculum for Child and Adolescent Psychiatry Training Programs.

Child and adolescent psychiatrists (CAP) care for high school students preparing to enter college. They also may continue to see students while on school vacations and may care for college students in various settings (emergency room, inpatient hospital unit, private practice, college student health service, or counseling center). As increasing numbers of students with mental health diagnoses pursue secondary education, CAP need to be knowledgeable about campus systems of care, principles of transition, and privacy and educational laws affecting college students.

[A diseased esophagus is frequently the cause of chronic hiccup. A prospective study of 184 cases].

Introduction: Chronic hiccup, defined as repetitive hiccup spells during more than 48 h, is an uncommon and neglected pathological condition, in which preliminary findings suggested an upper digestive origin.

Methods: We prospectively included 184 rebel chronic hiccups in this clinical and endoscopic study. Our rule of thumb was to consider upper digestive findings as first-rank in imputability and thus to treat them in priority.

Two early descriptions of restless legs syndrome and periodic leg movements by Boissier de Sauvages (1763) and Gilles de la Tourette (1898).

Boissier de Sauvages de La Croix and Gilles de la Tourette, French neurologists, noticed that patients with "anxiety in the lower limbs, shooting pain, tingling legs" may have an insomnia "at the time of wake-sleep transition [and] experience sudden jerks in the lower limbs." Their descriptions confirm that the clinical features of RLS were previously described in French literature in the 18th century.

Source of human ventilatory chaos: lessons from switching controlled mechanical ventilation to inspiratory pressure support in critically ill patients.

Ventilatory flow measured at the airway opening in humans exhibits a complex dynamics that has the features of chaos. Currently available data point to a neural origin of this feature, but the role of respiratory mechanics has not been specifically assessed. In this aim, we studied 17 critically ill mechanically ventilated patients during a switch form an entirely machine-controlled assistance mode (assist-controlled ventilation ACV) to a patient-driven mode (inspiratory pressure support IPS).

Eating disorder and metabolism in narcoleptic patients.

Study Objective: To evaluate eating behavior and energy balance as a cause of increased body mass index (BMI) in narcolepsy.

Design: Case controlled pilot study.

Settings: University hospital.

REM sleep behavior disorder in patients with guadeloupean parkinsonism, a tauopathy.

Study Objective: To describe sleep characteristics and rapid eye movement (REM) sleep behavior disorder in patients with Guadeloupean atypical parkinsonism (Gd-PSP), a tauopathy resembling progressive supranuclear palsy that mainly affects the midbrain. It is possibly caused by the ingestion of sour sop (corossol), a tropical fruit containing acetogenins, which are mitochondrial poisons.

Design: Sleep interview, motor and cognitive tests, and overnight videopolysomnography.

Invasive pulmonary aspergillosis in patients with decompensated cirrhosis: case series.

Background: Opportunistic invasive fungal infections are increasingly frequent in intensive care patients. Their clinical spectrum goes beyond the patients with malignancies, and for example invasive pulmonary aspergillosis has recently been described in critically ill patients without such condition. Liver failure has been suspected to be a risk factor for aspergillosis.

Restoration of normal motor control in Parkinson's disease during REM sleep.

Although normal subjects do not move during REM sleep, patients with Parkinson's disease may experience REM sleep behaviour disorder (RBD). The characteristics of the abnormal REM sleep movements in RBD have, however, not been studied. We interviewed one hundred consecutive non-demented patients with Parkinson's disease and their bed partners using a structured questionnaire assessing the presence of RBD.

Inspiratory resistances facilitate the diaphragm response to transcranial stimulation in humans.

Background: Breathing in humans is dually controlled for metabolic (brainstem commands) and behavioral purposes (suprapontine commands) with reciprocal modulation through spinal integration. Whereas the ventilatory response to chemical stimuli arises from the brainstem, the compensation of mechanical loads in awake humans is thought to involve suprapontine mechanisms. The aim of this study was to test this hypothesis by examining the effects of inspiratory resistive loading on the response of the diaphragm to transcranial magnetic stimulation.