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Warparkowski A. [High chance of healing for opiate dependent patients]. MMW Fortschr Med 2016; 158:75. [PMID: 27119898 DOI: 10.1007/s15006-016-7893-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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2
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Remy AJ, Wenger H, Bouchkira H. [Treatment of chronic hepatitis C in drug users: ethic, successful and useful]. Presse Med 2014; 43:1314-6. [PMID: 25307441 DOI: 10.1016/j.lpm.2014.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 08/25/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- André-Jean Remy
- Centre hospitalier de Perpignan, équipe mobile hépatites, 20, avenue du Languedoc, 66046 Perpignan, France.
| | - Hugues Wenger
- Centre hospitalier de Perpignan, équipe mobile hépatites, 20, avenue du Languedoc, 66046 Perpignan, France
| | - Hakim Bouchkira
- Centre hospitalier de Perpignan, équipe mobile hépatites, 20, avenue du Languedoc, 66046 Perpignan, France
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Chen W, Xia Y, Hong Y, Hall BJ, Ling L. Predictors of continued HIV-risk behaviors among drug users in methadone maintenance therapy program in China--a prospective study. Harm Reduct J 2013; 10:23. [PMID: 24107380 PMCID: PMC3853934 DOI: 10.1186/1477-7517-10-23] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 09/30/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To examine the predictors of continued drug- and sex-related HIV-risk behaviors among drug users in methadone maintenance therapy (MMT) programs in China. METHODS We followed a sample of 5,035 drug users enrolled for the first time in MMT programs at baseline, 6 months, and 12 months utilizing a longitudinal prospective study design. Drug users' HIV-risk behaviors, MMT characteristics, and drug use, were assessed at all three waves using a structured interview and HIV/HCV status was assessed at baseline and 12-month follow-up using biological specimens. RESULTS The point prevalence of HIV was 7.6% and 78.4% for HCV at baseline. Results of generalized linear mixed logistic regression models revealed that HIV-positive MMT clients were more likely to engage in drug injection (aOR = 1.70) and syringe sharing (aOR = 4.73). HCV-positive clients were more likely to inject drugs (aOR = 2.58), share syringes (aOR = 1.97), and have multiple sexual partners (aOR = 1.47). Adherence to MMT was the most significant predictor of reduced HIV-risk behaviors. CONCLUSIONS Our data confirmed the positive effects of MMT on HIV prevention and underscored the urgency for programs to reduce HIV risk in HIV- and HCV-positive clients. There is a pressing need to strengthen existing counseling services for HIV-positive drug users to reduce their drug-related risk behaviors and to provide counseling for HCV-positive drug users. Further studies are needed to explore interventions to address high dropout rates and low adherence among MMT clients.
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Affiliation(s)
- Wen Chen
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, #74, Zhongshan Road II, Guangzhou 510080, P.R China
- Sun Yat-sen Center for Migrant Health Policy, #74, Zhongshan Road II, Guangzhou 510080, P.R China
| | - Yinghua Xia
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, #74, Zhongshan Road II, Guangzhou 510080, P.R China
- Sun Yat-sen Center for Migrant Health Policy, #74, Zhongshan Road II, Guangzhou 510080, P.R China
| | - Yan Hong
- Department of Social and Behavioral Health School of Rural Public Health Texas A&M University, TAMU 1266, College Station, TX 77843-1266, USA
| | - Brian J Hall
- Sun Yat-sen Center for Migrant Health Policy, #74, Zhongshan Road II, Guangzhou 510080, P.R China
- UNC-Project China, Guangdong STD Control Center, Guangzhou 510095, P.R China
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 8th Floor, 624 N. Broadway, Baltimore, MD 21205, USA
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, #74, Zhongshan Road II, Guangzhou 510080, P.R China
- Sun Yat-sen Center for Migrant Health Policy, #74, Zhongshan Road II, Guangzhou 510080, P.R China
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Frolov VM, Sotskaia IA, Kruglova OV. [Influence of immunotropic preparation cycloferon and phytopreparations of Cynara scolimus L. on blood cytokines profile of the patients with chronic viral hepatitis C in medical rehabilitation period]. Lik Sprava 2012:102-107. [PMID: 23035608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The effect of the immunotropic drug cycloferon and herbal medicine resources on the basis of Cynara scolimus L. on the blood cytokine profile in the patients with chronic viral hepatitis C (CVHC) in medical rehabilitation (MR) period. Established that prior to MR period in the patients with CVHC was noted significantly increased levels of proinflammatory cytokines (CK) at the blood serum, and the level of antiinflammatory CK changed significantly. The use of cycloferon and herbal medicine resources on the basis of Cynara scolimus L. in the MR complex provided to normalize the studied CK concentration in the serum of the patients with CVHC.
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Mettler J, Battegay E, Zimmerli L. [Chronic fatigue. IV--Assessment of a 40-year-old patient]. Praxis (Bern 1994) 2007; 96:1773-1775. [PMID: 18050603 DOI: 10.1024/1661-8157.96.45.1773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A forty year old patient was referred by the federal insurance for medical assessment. His presenting complaint was chronic fatigue. The patient had been an intravenous drug user for years and had been infected with hepatitis C. He was treated with interferon. The patient history showed that he also suffered from anaemia and depression. He participated in a methadone substitution program. Our diagnostic procedures showed that he also has Hashimoto's thyroiditis.
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Affiliation(s)
- J Mettler
- Medizinische Poliklinik, Universitätsspital Basel
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Watson B, Conigrave KM, Wallace C, Whitfield JB, Wurst F, Haber PS. Hazardous alcohol consumption and other barriers to antiviral treatment among hepatitis C positive people receiving opioid maintenance treatment. Drug Alcohol Rev 2007; 26:231-9. [PMID: 17454012 DOI: 10.1080/09595230701247681] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study.
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MESH Headings
- Adolescent
- Adult
- Alcoholism/epidemiology
- Alcoholism/rehabilitation
- Antiviral Agents/therapeutic use
- Anxiety Disorders/epidemiology
- Anxiety Disorders/rehabilitation
- Australia
- Buprenorphine/therapeutic use
- Comorbidity
- Cross-Sectional Studies
- Depressive Disorder, Major/epidemiology
- Depressive Disorder, Major/rehabilitation
- Drug Therapy, Combination
- Female
- Follow-Up Studies
- Health Knowledge, Attitudes, Practice
- Health Services Accessibility/statistics & numerical data
- Hepatitis B, Chronic/epidemiology
- Hepatitis B, Chronic/rehabilitation
- Hepatitis C, Chronic/epidemiology
- Hepatitis C, Chronic/rehabilitation
- Humans
- Male
- Mass Screening
- Methadone/therapeutic use
- Middle Aged
- Narcotics/therapeutic use
- Opioid-Related Disorders/epidemiology
- Opioid-Related Disorders/rehabilitation
- Patient Acceptance of Health Care/statistics & numerical data
- Patient Satisfaction
- Psychotherapy, Brief
- Substance Abuse, Intravenous/epidemiology
- Substance Abuse, Intravenous/rehabilitation
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7
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Kronenberger B, Berg T, Herrmann E, Hinrichsen H, Gerlach T, Buggisch P, Spengler U, Goeser T, Nasser S, Wursthorn K, Pape GR, Hopf U, Zeuzem S. Efficacy of amantadine on quality of life in patients with chronic hepatitis C treated with interferon-alpha and ribavirin: results from a randomized, placebo-controlled, double-blind trial. Eur J Gastroenterol Hepatol 2007; 19:639-46. [PMID: 17625432 DOI: 10.1097/meg.0b013e3281ac20ca] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
AIM The aim of this study was to investigate whether amantadine reduces deterioration of quality of life in patients with chronic hepatitis C during and after treatment with interferon-alpha (IFN-alpha) and ribavirin. PATIENTS AND METHODS In this randomized, prospective, placebo-controlled, multicenter trial, previously untreated patients with chronic hepatitis C were treated with IFN-alpha plus ribavirin [17] and randomized for treatment with amantadine (200 mg/day, orally, n=136) or placebo (n=131). Quality of life was assessed with the 'Profile of Mood States' scale and the 'Everyday Life' questionnaire at baseline, treatment week (TW) 8, TW24, TW48, and at follow-up. RESULTS Early during treatment at TW8, quality of life was not different between patients in the control and the amantadine group. At TW24, the control group but not the amantadine group, however, showed significant deterioration of the modalities depression, fatigue, and vigor compared with baseline. Especially, nonresponders in the amantadine group showed significantly lower deterioration of depression, anger, mind function, everyday life, and zest for life than those in the placebo group. After treatment, the beneficial effects of amantadine disappeared. CONCLUSION The addition of amantadine to IFN-alpha plus ribavirin combination therapy may reduce deterioration of depression, fatigue, and vigor during treatment but does not affect quality of life after treatment.
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Affiliation(s)
- Bernd Kronenberger
- Department of Medicine I, Johann Wolfgang Goethe University Medical Center, Frankfurt/M, Germany
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8
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Litwin AH, Kunins HV, Berg KM, Federman AD, Heavner KK, Gourevitch MN, Arnsten JH. Hepatitis C management by addiction medicine physicians: results from a national survey. J Subst Abuse Treat 2007; 33:99-105. [PMID: 17379472 PMCID: PMC2929905 DOI: 10.1016/j.jsat.2006.12.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Accepted: 12/11/2006] [Indexed: 01/12/2023]
Abstract
Drug users are disproportionately affected by hepatitis C virus (HCV), yet they face barriers to health care that place them at risk for levels of HCV-related care that are lower than those of nondrug users. Substance abuse treatment physicians may treat more HCV-infected persons than other generalist physicians, yet little is known about how such physicians facilitate HCV-related care. We conducted a nationwide survey of American Society of Addiction Medicine physicians (n = 320) to determine substance abuse physicians' HCV-related management practices and to describe factors associated with these practices. We found that substance abuse treatment physicians promote several elements of HCV-related care, including screening for HCV antibodies, recommending vaccinations against hepatitis A and B, and referring patients to subspecialists for HCV treatment. Substance abuse physicians who also provide primary medical or HIV-related care were most likely to facilitate HCV-related care. A significant minority of physicians were either providing HCV antiviral treatment or willing to provide HCV antiviral treatment.
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Affiliation(s)
- Alain H Litwin
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.
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9
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Abstract
BACKGROUND Many physicians are still skeptic to treat opioid dependants, with or without maintenance treatment, for hepatitis C (HCV) because of concerns about psychiatric comorbidity, stability and adherence. In Norway, there are about 3,500 patients participating in the restrictive medication-assisted rehabilitation (LAR) programs in which all patients are given methadone or buprenorphine maintenance therapy. This study was undertaken to determine whether HCV combination therapy with pegylated interferon alpha-2a plus ribavirin is feasible, efficient and safe in this patient group. METHOD Seventeen patients with HCV genotype 3a were treated for 24 weeks. To optimize compliance, the treatment was given from a department of infectious diseases in cooperation with an LAR center. All injections were given in the LAR center and the patients were given psychosocial support. RESULTS The compliance was 100%. All responded to the therapy and 16 (94%) were sustained responders. DISCUSSION/CONCLUSION This study indicates that compliance and treatment outcome of opioid dependants on methadone or buprenorphine maintenance after 24 weeks of HCV treatment corresponds to that for non-dependants if extra support is given. The treatment should be undertaken in collaboration with specialists in addiction medicine, hepatology and infectious diseases.
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Affiliation(s)
- Aud L Krook
- Unit for Addiction Medicine, Institute of Psychiatry, University of Oslo, and Clinic of Abuse and Dependence, Aker University Hospital HF, Oslo, Norway.
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10
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Palepu A, Cheng DM, Kim T, Nunes D, Vidaver J, Alperen J, Saitz R, Samet JH. Substance abuse treatment and receipt of liver specialty care among persons coinfected with HIV/HCV who have alcohol problems. J Subst Abuse Treat 2006; 31:411-7. [PMID: 17084795 PMCID: PMC1995458 DOI: 10.1016/j.jsat.2006.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 05/04/2006] [Accepted: 05/16/2006] [Indexed: 12/20/2022]
Abstract
We examined the association of substance abuse treatment with access to liver specialty care among 231 persons coinfected with HIV and hepatitis C virus (HCV) with a history of alcohol problems who were recruited and followed up in the HIV-Longitudinal Interrelationships of Viruses and Ethanol cohort study from 2001 to 2004. Variables regarding demographics, substance use, health service use, clinical variables, and substance abuse treatment were from a standardized research questionnaire administered biannually. We defined substance abuse treatment services as any of the following in the previous 6 months: 12 weeks in a halfway house or residential facility, 12 visits to a substance abuse counselor or mental health professional, day treatment for at least 30 days, or any participation in a methadone maintenance program. Liver specialty care was defined as a visit to a liver doctor, a hepatologist, or a specialist in treating hepatitis C in the past 6 months. At study entry, most of the 231 subjects (89%, n = 205) had seen a primary care physician, 50% had been exposed to substance abuse treatment, and 50 subjects (22%) had received liver specialty care. An additional 33 subjects (14%) reported receiving liver specialty care during the follow-up period. In the multivariable model, we observed a clinically important although not statistically significant association between having been in substance abuse treatment and receiving liver specialty care (adjusted odds ratio = 1.38; 95% confidence interval = 0.9-2.11). Substance abuse treatment systems should give attention to the need of patients to receive care for prevalent treatable diseases such as HIV/HCV coinfection and facilitate its medical care to improve the quality of care for individuals with substance use disorders. The data illustrate the need for clinical care models that give explicit attention to the coordination of primary health care with addiction and hepatitis C specialty care while providing ongoing support to engage and retain these patients with complex health needs.
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Affiliation(s)
- Anita Palepu
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Department of Medicine, University of British Columbia, Vancouver, BC, Canada V6Z 1Y6.
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11
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Abstract
HISTORY AND FINDINGS A 37-year-old man with a 19-years history of injection drug use (IDU) who had acquired a chronic hepatitis C virus (HCV-) infection 9 years ago, entered the German clinical study on heroine assisted treatment ("Modellprojekt zur heroingestützten Behandlung Opiatabhängiger"). Before study onset he received buprenorphine maintainance treatment, while at the same time engaging in illicit IDU (heroine, cocaine). He lived in a caravan and was on social welfare. INVESTIGATIONS PCR revealed a genotype 2 and an HCV-viral load of 310,000 IU/ml. Liver biopsy showed a moderate chronic active hepatitis and a mild portal fibrosis without signs of liver cirrhosis. DIAGNOSIS, TREATMENT AND COURSE Within the heroine-assisted treatment program the patient injected heroine under medical supervision several times a day and attended the standardized psychosocial program that comprised an intensive education on HCV-infection. Within a period of ten months of physical and social stabilization he managed to stop illicit drug use, found stable housing and started to work. We then initiated treatment of HCV-infection. Subcutaneous pegylated interferon alpha-2a, peroral ribavirin and intravenous heroine were administered as directly observed therapy. Based on the close mashed care of the heroine assisted treatment setting, side effects were well controllable and reversible after the end of antiviral therapy. A sustained response was obtained. CONCLUSION After careful indication, heroine-assisted treatment with particularly intensive medical and psychological care can offer appropriate conditions for a save and successful treatment of hepatitis C as well as for a sustained result.
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Affiliation(s)
- P Deibler
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychosomatik und Psychotherapeutische Medizin.
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12
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Kramer L, Hofer H, Bauer E, Funk G, Formann E, Steindl-Munda P, Ferenci P. Relative impact of fatigue and subclinical cognitive brain dysfunction on health-related quality of life in chronic hepatitis C infection. AIDS 2005; 19 Suppl 3:S85-92. [PMID: 16251834 DOI: 10.1097/01.aids.0000192075.26314.87] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To assess the relative impact of fatigue and subclinical cognitive brain dysfunction on the impairment of health-related quality of life (HRQL) in hepatitis C virus (HCV) infection. DESIGN AND METHODS We performed a cross-sectional study in 120 patients with untreated chronic HCV infection to test the hypothesis that the severity of fatigue had an independent effect on HCV-associated impairment of HRQL. Patients were investigated using the short-form-36 questionnaire, the fatigue impact scale, the brief fatigue inventory, and P300 event-related potentials, as an objective correlate of neurocognitive function. Patients with decompensated cirrhosis or clinical depression were excluded. RESULTS Relative to healthy controls, HCV-infected patients showed significant levels of fatigue (Fatigue Impact Scale, 49 versus 26 points, brief fatigue inventory, 3.0 versus 1.6 points, P < 0.001). Fatigue impact scale and brief fatigue inventory scores were highly correlated (r = 0.77, P < 0.001), demonstrating concurrent validity. Severity of fatigue and age were the only factors independently associated with the impairment of HRQL (P < 0.001). Fatigue was not related to the severity of hepatitis or the degree of subclinical brain dysfunction. CONCLUSION In untreated patients with chronic HCV infection, fatigue severity and age but not neurocognitive dysfunction or hepatic function are independently associated with impaired HRQL. Both the fatigue impact scale and the brief fatigue inventory are suitable tools to assess the subjective burden of fatigue. Our findings stress the need for effective therapeutic interventions to reduce the burden of fatigue in patients with HCV infection.
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Affiliation(s)
- Ludwig Kramer
- Department of Medicine IV, Medical University Vienna, Austria.
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13
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Tarantino G, Conca P, Sorrentino P, Ariello M, Mastrolia M, Di Minno MND. Is the quality of life always depressed in patients with chronic hepatitis C on antiviral therapy? Eur J Gastroenterol Hepatol 2005; 17:999. [PMID: 16093881 DOI: 10.1097/00042737-200509000-00019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Giovanni Tarantino
- Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Italy
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14
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Abstract
Chronic hepatitis C (HCV) varies greatly in its course and outcomes. Reports of fatigue and other symptoms are common during treatment and when patients are not receiving treatment. Exercise as a form of treatment for HCV-related fatigue has had little attention in research studies, yet data from studies in closely related chronic conditions consistently report the value of exercise for maintaining and improving health and reducing risk factors. This article examines the factors influencing the development of an exercise protocol as an adjunct to health promotion in patents with HCV. A review of the current literature summarizes findings from the areas of exercise in chronic illness states, exercise measures, and exercise prescription as treatment for chronic illnesses, with a focus on HCV. Nurses should consider these factors when developing an exercise protocol as an alternative treatment for side effects and symptoms related to hepatitis C and other chronic conditions. More research on specific exercise prescriptions should be undertaken and reported in the literature.
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Affiliation(s)
- Mary Ann Gapinski
- F. W. Parker Charter Essential School, Devens, Massachusetts 01434, USA.
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15
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Oehler G. [Social-medical aspects of chronic liver diseases]. Versicherungsmedizin 2004; 56:170-3. [PMID: 15633768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
In our country liver diseases are frequent and have many different causes. They can often develop into cirrhosis of the liver with mortality beetween 13.5% and 24.5%. Hepatitis B and C-viral infections frequently play a significant role in the recognition of an occupational disease in the case of medical staff, with histological criteria of major importance in this respect. A consequence of cirrhosis of the liver may be the development of hepatoencephalopathia of varying degrees of severity. As it is then likely that a patient will no longer be able to drive motor vehicles, it is important that attending physicians inform their patients accordingly. Liver transplants are an acknowledged method of treatment in the therapy of advanced liver cirrhosis. Rehabilitation shortly after transplantation is highly important to help ensure a speedy return to work. Surprisingly, reintegration is more difficult in patients suffering from alcohol related liver disease than in those with non-alcohol-related liver disease.
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MESH Headings
- Biopsy
- Causality
- Cross-Sectional Studies
- Disability Evaluation
- Germany
- Hepatic Encephalopathy/etiology
- Hepatic Encephalopathy/mortality
- Hepatic Encephalopathy/pathology
- Hepatic Encephalopathy/rehabilitation
- Hepatitis B, Chronic/mortality
- Hepatitis B, Chronic/pathology
- Hepatitis B, Chronic/rehabilitation
- Hepatitis C, Chronic/mortality
- Hepatitis C, Chronic/pathology
- Hepatitis C, Chronic/rehabilitation
- Hepatitis, Alcoholic/mortality
- Hepatitis, Alcoholic/pathology
- Hepatitis, Alcoholic/rehabilitation
- Humans
- Liver/pathology
- Liver Cirrhosis/etiology
- Liver Cirrhosis/mortality
- Liver Cirrhosis/pathology
- Liver Cirrhosis/rehabilitation
- Liver Diseases/etiology
- Liver Diseases/mortality
- Liver Diseases/pathology
- Liver Diseases/rehabilitation
- Liver Transplantation/rehabilitation
- Occupational Diseases/etiology
- Occupational Diseases/mortality
- Occupational Diseases/pathology
- Prognosis
- Rehabilitation, Vocational
- Survival Rate
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16
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Affiliation(s)
- G Gallucci
- Department of Psychiatry, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA
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17
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Abstract
Hepatitis C viral infection with its sequelae is a significant healthcare problem. Hepatitis C infects nearly 4 million Americans with almost half of these unaware of their infection. Many of those individuals infected with hepatitis C develop chronic hepatitis C and in 15% of these patients, the infection will progress to cirrhosis within 20 years. Several cross-sectional and longitudinal studies have demonstrated the negative impact of chronic hepatitis C on health-related quality of life. This review describes what is currently known about the impact of chronic hepatitis C on health-related quality of life during pharmacologic treatment and after liver transplantation. It is important to note that few studies have prospectively followed patients over time with respect to quality of life or examined other factors including symptoms, markers of disease progression, or host immune function. Studies suggest that patients with chronic hepatitis C, even without major disease-related complications, perceive themselves to be unwell and have significant changes in their physical and mental well being. Such results have important implications for nursing care and management. Intervention studies focused on self-care management with an emphasis on symptom reduction are warranted.
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Affiliation(s)
- M Heitkemper
- School of Nursing, Department of Biobehavioral Nursing and Health Systems, Box 357266, University of Washington, Seattle, Washington 98195, USA
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