Introduction Cardiomyopathy is a common cause of morbidity and death in patients with Duchenne muscular dystrophy (DMD). Methods A cross-sectional analysis of clinical data from a multi-institutional, international CINRG DMD Natural History Study of 340 DMD patients aged 2 to 28 years. Cardiomyopathy was defined as shortening fraction (SF) <28% or ejection fraction (EF) <55%. Results 231 participants reported a prior clinical echocardiogram study, and 174 had data for SF or EF. The prevalence of cardiomyopathy was 27% (47/174), and it was significantly associated with age and clinical stage. The association of cardiomyopathy with age and clinical stage was not changed by glucocorticoid use as a covariate (P>0.68). In patients with cardiomyopathy, 57 % (27/47) reported not taking any cardiac medications. Cardiac medications were used in 12% (15/127) of patients without cardiomyopathy. Discussion Echocardiograms were underutilized, and cardiomyopathy was undertreated in this DMD natural history cohort.

Time and space constraints, large class sizes, competition for clinical internships, and geographic separation between classroom and clinical rotations for student interaction with peers and faculty pose challenges for health professions educational programs. This article presents a model for effectively incorporating technology to overcome these challenges and enhance student engagement and interaction in traditionally face-to-face (FTF) health professions (physical therapy and physician assistant) curricula across learning environments (classroom to clinic). Four faculty members interested in redesigning a course or course unit(s) met with the IMPACT (Instructional Media and Programming to Advance Collaboration and Teaching) Initiative instructional design team. Instructional designers provided education, training, and support to faculty for increased use of technology within courses. Four exemplars using Blackboard, videos, VoiceThread ® , and Twitter ® are described. Themes and "lessons learned" were developed from each of the exemplars. A model emerged for integrating technology into health professions curricula with an emphasis on engaging students in active, realistic, and social learning environments. This model demonstrates how technology can be integrated successfully into traditionally FTF health professions curricula to support learning outcomes essential for practice.