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Younossi ZM, Kremer AE, Swain MG, Jones D, Bowlus C, Trauner M, Henry L, Gerber L. Assessment of fatigue and its impact in chronic liver disease. J Hepatol 2024; 81:726-742. [PMID: 38670320 DOI: 10.1016/j.jhep.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Patient-reported outcomes (PROs), such as health-related quality of life (HRQL), are important outcome measures for patients with chronic liver diseases (CLDs). Presence of cirrhosis and advanced liver disease have been associated with worsened HRQL and fatigue. On the other hand, some patients with earlier stages of CLD also experience fatigue, causing PRO impairment. Treatment for some CLDs may improve HRQL and, sometimes, levels of fatigue. We aimed to provide an in-depth expert review of concepts related to fatigue and HRQL in patients with primary biliary cholangitis, hepatitis C virus and MASLD (metabolic dysfunction-associated steatotic liver disease). A panel of experts in fatigue and CLD reviewed and discussed the literature and collaborated to provide this expert review of fatigue in CLD. Herein, we review and report on the complexity of fatigue, highlighting that it is comprised of peripheral (neuromuscular failure, often in conjunction with submaximal cardiorespiratory function) and central (central nervous system dysfunction) causes. Fatigue and HRQL are measured using validated self-report instruments. Additionally, fatigue can be measured through objective tests (e.g. grip strength). Fatigue has deleterious effects on HRQL and one's ability to be physically active and socially engaged but does not always correlate with CLD severity. Treatments for hepatitis C virus and MASLD can improve levels of fatigue and HRQL, but current treatments for primary biliary cholangitis do not seem to affect levels of fatigue. We conclude that obtaining PRO data, including on HRQL and fatigue, is essential for determining the comprehensive burden of CLD and its potential treatments.
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Affiliation(s)
- Zobair M Younossi
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; The Global Liver Council, Washington DC, USA.
| | - Andreas E Kremer
- Department of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Mark G Swain
- Professor of Medicine, Cal Wenzel Family Foundation Chair in Hepatology, University of Calgary Liver Unit, Calgary, Canada
| | - David Jones
- Professor of Liver Immunology, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Bowlus
- Lena Valente Professor and Chief, Division of Gastroenterology and Hepatology, University of California Davis, United States
| | - Michael Trauner
- Div. of Gastroenterology & Hepatology, Dept. of Internal Medicine III, MedUni Wien, Medical University of Vienna, Austria
| | - Linda Henry
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; The Global Liver Council, Washington DC, USA; Center for Outcomes Research in Liver Diseases, Washington DC, USA
| | - Lynn Gerber
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; The Global Liver Council, Washington DC, USA
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de Ledinghen V, Hanslik B, Moussalli J, Si Ahmed SN, Ouzan D, Larrey D. Hepatitis C virus infection impacts work productivity and fatigue: An epidemiologic real-life study. Ann Hepatol 2020; 18:708-714. [PMID: 31164266 DOI: 10.1016/j.aohep.2019.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVE Hepatitis C virus (HCV) infection and treatment impact the patient's daily life and work productivity. Until recently, treatments were associated with side effects and insufficient virologic and hepatic results. This study evaluated fatigue, work productivity, and treatment modalities in patients with HCV infection. MATERIALS AND METHODS This cross-sectional, non-interventional, multicenter study was conducted in real-life settings between March and December 2015 at 109 sites in France. RESULTS Data from 1269 patients were evaluable. The mean patient age was 55.8±12.5 years; 53.3% (676) patients were male. A total of 80.1% (1015) of patients were Caucasian and 62.3% (791) had a genotype 1 infection, 34.2% (433) had at least one comorbidity and 15.6% (198) had ≥1 clinical sign/symptom. Illicit drug use was the main route of HCV transmission and accounted for 36.8% (466) of all infections. Fibrosis stage F0/F1 was reported in 41.4% (525) of patients. A majority of patients (60.4%, 764) had never been treated. In patients previously treated, 85.8% (430) received ribavirin and pegylated interferon and only 13.4% (67) direct-acting antivirals. The mean percent of global impairment due to health was highest (34.8±30.9%) in patients 18-45 years of age. The prevalence of active employed patients with a total fatigue score≥its median value (45/160) was 38.6%. The mean percent work time missed due to health was 9.6±23.6% for working patients of 18-45 years of age and 7.3±21.8% for working patients of 45-65 years of age. The mean overall prevalence of employed patients with impairment due to health issues was 21.8±26.8%. The prevalence of patients with a reduced work activity of ≥50% due to their health status was 32.1%. CONCLUSION These data reinforce the request for improved disease management in France, allowing patients with HCV infection to increase work productivity, reduce fatigue, and, hopefully, cure their disease.
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Affiliation(s)
- Victor de Ledinghen
- Hepatology Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France.
| | | | | | | | - Denis Ouzan
- Private Practice, St. Laurent du Var, France
| | - Dominique Larrey
- Hepatology Unit, University Hospital Montpellier, Montpellier, France
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Abstract
Fatigue is one of the most common patient-reported symptoms and can result in poor quality of life in patients with the hepatitis B virus (HBV). Little is known about the characteristics of fatigue in Korean patients with HBV. This study's purpose was to examine fatigue severity and explore health issues associated with fatigue in Korean patients with HBV. A mixed-methods research design was used. Quantitative data on fatigue severity were measured using the revised Piper Fatigue Scale (PFS) with 147 participants. Qualitative data on health issues induced by fatigue were collected via interviews with11 participants. Content analysis revealed three categories of health issues (physical, psychological, and social) and eight subcategories. Participants' overall fatigue level was moderate. The cognitive/mood dimension on the PFS had a significant negative correlation with age. Emotional and psychosocial issues associated with HBV-related fatigue may be more prevalent than physical issues in Korean patients.
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Huang R, Rao H, Shang J, Chen H, Li J, Xie Q, Gao Z, Wang L, Wei J, Jiang J, Sun J, Jiang J, Wei L. A cross-sectional assessment of health-related quality of life in Chinese patients with chronic hepatitis c virus infection with EQ-5D. Health Qual Life Outcomes 2018; 16:124. [PMID: 29903024 PMCID: PMC6003185 DOI: 10.1186/s12955-018-0941-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/21/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China. METHODS In this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D. RESULTS Nine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = - 0.134; 2000-4999 RMB, β = - 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.090), disease profile (cirrhosis, β = - 0.114), hyperlipidemia (β = - 0.065) and depression (β = - 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = - 0.129; 2000-4999 RMB, β = - 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.091), disease profile and depression (β = - 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D. CONCLUSIONS In this cross-sectional assessment of HCV patients in China, we indicated HRQoL of Chinese HCV patients. Significant negative associations between HRQoL and sociodemographic and clinical factors such as moderate or severe symptoms of discomfort, disease profile and depression emerged. We have to focus on optimally managing care of HCV patients and improving their HRQoL. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT01293279. Date of registration: February 10, 2011.
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Affiliation(s)
- Rui Huang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver Disease, Beijing, China
| | - Huiying Rao
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver Disease, Beijing, China
| | - Jia Shang
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Hong Chen
- First Hospital of Lanzhou University, Lanzhou, China
| | - Jun Li
- First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Qing Xie
- Shanghai Ruijin Hospital, Shanghai, China
| | - Zhiliang Gao
- Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lei Wang
- Second Hospital of Shandong University, Jinan, China
| | - Jia Wei
- First Affiliated Hospital of Kunming Medical College, Kunming, China
| | - Jianning Jiang
- First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jian Sun
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiaji Jiang
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lai Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver Disease, Beijing, China.
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Maccauro G, Tetè S, Saggini A, Tripodi D, Castellani M, Conti F, Cianchetti E, Conti C, Rosati M, Toniato E, Fulcheri M, Salini V, Caraffa A, Antinolfi P, Frydas S, Torello M, Neri G, Pandolfi F, Conti P, Theoharides T. Induction of CCL2 (MCP-1) BY IL-33 in Human Umbelical Cord Blood Mast Cells. EUR J INFLAMM 2017. [DOI: 10.1177/1721727x1201000207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- G. Maccauro
- Orthopedics Division, Università Cattolica, Rome, Italy
| | - S. Tetè
- Dental School, University of Chieti-Pescara, Italy
| | - A. Saggini
- Orthopedics Division, University of Chieti-Pescara, Italy
| | - D. Tripodi
- Dental School, University of Chieti-Pescara, Italy
| | | | - F. Conti
- Gynecology Division, S. Spirito Hospital, Pescara, Italy
| | | | - C.M. Conti
- Psychology Faculty, University of Chieti, Italy
| | - M. Rosati
- Surgery Division, Ortona Hospital, Ortona, Italy
| | - E. Toniato
- Immunology Division, University of Chieti-Pescara, Italy
| | - M. Fulcheri
- Psychology Faculty, University of Chieti, Italy
| | - V. Salini
- Orthopedics Division, Chieti-Pescara University, Italy
| | - A. Caraffa
- Orthopedics Division, University of Perugia, Perugia, Italy
| | - P. Antinolfi
- Orthopedics Division, University of Perugia, Perugia, Italy
| | - S. Frydas
- Laboratory of Parasitology, Veterinary Faculty, Aristotelian University, Thessaloniki, Greece
| | - M. Torello
- Clinical Pathology, University of Chieti-Pescara, Italy
| | - G. Neri
- ENT Division, University of Chieti, Italy
| | - F. Pandolfi
- Department of Medicine, Catholic University of Rome, Rome, Italy
| | - P. Conti
- Immunology Division, University of Chieti-Pescara, Italy
| | - T.C. Theoharides
- Department of Physiology and Pharmacology, Tufts University School of Medicine, New England Medical Center, Boston, MA, USA
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Franc M, Michalski B, Kuczerawy I, Szuta J, Skrzypulec-Plinta V. Cancer related fatigue syndrome in neoplastic diseases. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2014; 13:352-5. [PMID: 26327879 PMCID: PMC4352912 DOI: 10.5114/pm.2014.47989] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/06/2014] [Accepted: 11/17/2014] [Indexed: 01/31/2023]
Abstract
Fatigue is one of the most important factors which has a considerable influence on treatment and the life quality of oncological patients. The fatigue syndrome is often diagnosed during cancer treatment and this syndrome is not related to the physical effort. Cancer related fatigue is a patient's subjective, psychologically, physically and emotionally based feeling. It is disproportionate to patient's daily activity. The pathogenesis of this syndrome remains still unknown. However, on the basis of various questionnaires, it is possible to test the disease's complex nature. Cancer related fatigue causes deterioration of patient's life along with lower motivation to struggle with the disease. It is thought that the factor which increases the incidence of cancer related fatigue is a long-term use of drugs such as opioids, benzodiazepine, and medicines containing codeine, tranquilizers, anxiolytics and antidepressants. On the basis of the results, one can choose an appropriate treatment method for cancer related fatigue such as rehabilitation, psychotherapy or public assistance. A great number of patients consider excessive fatigue a typical concomitant symptom in neoplastic disease; therefore, they do not report it. It is of a paramount importance to make patients aware of the fact that cancer related fatigue is a serious disease which can be treated.
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Affiliation(s)
- Magdalena Franc
- Doctor Studies, Medical Department, Silesia Medical University, Katowice, Poland
| | - Bogdan Michalski
- Department of Gynecological Oncology, Women School of Health, Silesia Medical University, Katowice, Poland
| | - Ilona Kuczerawy
- Doctor Studies, Medical Department, Silesia Medical University, Katowice, Poland
| | - Justyna Szuta
- Doctor Studies, Medical Department, Silesia Medical University, Katowice, Poland
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Younossi ZM, Stepanova M, Henry L, Gane E, Jacobson IM, Lawitz E, Nelson D, Gerber L, Nader F, Hunt S. Effects of sofosbuvir-based treatment, with and without interferon, on outcome and productivity of patients with chronic hepatitis C. Clin Gastroenterol Hepatol 2014; 12:1349-59.e13. [PMID: 24316172 DOI: 10.1016/j.cgh.2013.11.032] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/17/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Interferon-based treatment of chronic hepatitis C virus (HCV) infection can negatively affect patient-reported outcomes (PROs) and work productivity (WP). We assessed these factors in patients with chronic hepatitis C treated with sofosbuvir and ribavirin, with or without pegylated interferon. METHODS The HCV-specific Quality of Life (Chronic Liver Disease Questionnaire-HCV version [CLDQ-HCV]), Functional Assessment of Chronic Illness Therapy-Fatigue, and Work Productivity and Activity Index: Specific Health Problem questionnaires were completed before, during, and after treatment of patients infected with HCV genotypes 2 or 3 who received sofosbuvir and ribavirin for 16 or 12 weeks (the FUSION study, n = 201) or patients infected with HCV genotype 1 who received pegylated interferon, sofosbuvir, and ribavirin for 12 weeks (the NEUTRINO study, n = 327). RESULTS Patients in each group of the FUSION study had similar PRO and WP scores at each time point (all comparisons, P > .05). Compared with baseline, patients had modest reductions in fatigue, HCV-specific quality of life, and WP and Activity Index scores during treatment (P = .02 to <.0001). However, by 4 weeks after treatment, all scores returned to baseline levels or higher. Subjects in the NEUTRINO study had greater reductions in these scores during treatment; most remained significant through 4 weeks after treatment (P < .05). Significant improvements in PROs were observed among patients with sustained virologic responses 12 weeks after treatment in the FUSION and NEUTRINO studies (all P < .05). In multivariate analyses after adjustment for confounders, interferon therapy was independently associated with worse PROs after 12 weeks of treatment. CONCLUSIONS On the basis of an analysis of 2 large clinical trials (FUSION and NEUTRINO), patient outcome and productivity are more negatively affected by the inclusion of pegylated interferon in treatment than by interferon-free regimens. Patients with sustained virologic responses 12 weeks after treatment had significant improvements in PROs in both studies.
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Affiliation(s)
- Zobair M Younossi
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia.
| | - Maria Stepanova
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia
| | - Linda Henry
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia
| | - Edward Gane
- Auckland City Hospital, Auckland, New Zealand
| | | | - Eric Lawitz
- Texas Liver Institute, University of Texas Health Science Center, San Antonio, Texas
| | | | - Lynn Gerber
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia
| | - Fatema Nader
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia
| | - Sharon Hunt
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia
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Maric D, Brkic S, Tomic S, Novakov Mikic A, Cebovic T, Turkulov V. Multivitamin mineral supplementation in patients with chronic fatigue syndrome. Med Sci Monit 2014; 20:47-53. [PMID: 24419360 PMCID: PMC3907507 DOI: 10.12659/msm.889333] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Chronic fatigue syndrome (CFS) is characterized by medically unexplained persistent or reoccurring fatigue lasting at least 6 months. CFS has a multifactorial pathogenesis in which oxidative stress (OS) plays a prominent role. Treatment is with a vitamin and mineral supplement, but this therapeutic option so far has not been properly researched. Material/Methods This prospective study included 38 women of reproductive age consecutively diagnosed by CDC definition of CFS and treated with a multivitamin mineral supplement. Before and after the 2-month supplementation, SOD activity was determined and patients self-assessed their improvement in 2 questionnaires: the Fibro Fatigue Scale (FFS) and the Quality of Life Scale (SF36). Results There was a significant improvement in SOD activity levels; and significant decreases in fatigue (p=0.0009), sleep disorders (p=0.008), autonomic nervous system symptoms (p=0.018), frequency and intensity of headaches (p=0.0001), and subjective feeling of infection (p=0.0002). No positive effect on quality of life was found. Conclusions Treatment with a vitamin and mineral supplement could be a safe and easy way to improve symptoms and quality of life in patients with CFS.
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Affiliation(s)
- Daniela Maric
- Clinic for Infectious Diseases, Clinical Center Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Snezana Brkic
- Clinic for Infectious Diseases, Clinical Center Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Slavica Tomic
- Clinic for Infectious Diseases, Clinical Center Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | | | - Tatjana Cebovic
- Biochemistry Department, Clinical Center Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vesna Turkulov
- Clinic for Infectious Diseases, Clinical Center Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Modabbernia A, Poustchi H, Malekzadeh R. Neuropsychiatric and psychosocial issues of patients with hepatitis C infection: a selective literature review. HEPATITIS MONTHLY 2013; 13:e8340. [PMID: 23550100 PMCID: PMC3582302 DOI: 10.5812/hepatmon.8340] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 08/20/2012] [Accepted: 10/08/2012] [Indexed: 02/07/2023]
Abstract
CONTEXT We briefly reviewed the evidence on the association of hepatitis C (HCV) infection with several aspects of mental and psychosocial health. EVIDENCE ACQUISITION Medline was searched with appropriate keywords. The primary sources were the systematic reviews. If systematic reviews were not available for a subject, then the most relevant and methodologically sound original studies were selected. RESULTS HCV infection is associated with poorer health-related quality of life, and physical, mental, and social health. A part of impaired health of these patients is related to cirrhosis, intravenous drug use, co morbid psychiatric disorders, stigmatization, poor social support, alcohol abuse, and interferon treatment. However, HCV itself is also associated with poorer health status particularly in the physical and cognitive domains, which might be related to brain alterations induced by the virus. Interferon treatment is an important cause of depression in HCV patients and sometimes is associated with irritability, manic episode, or acute confusional state. Social health of HCV patients is significantly impaired by stigmatization, poor social support, psychiatric comorbidties, and impaired coping. Psychosocial impairment of HCV patients significantly impairs their treatment adherence. A supportive and nonjudgmental multidisciplinary team is required for optimal management of these patients. CONCLUSIONS Patients with HCV infection had complex neuropsychiatric and psychosocial problems. These problems are challenges for management of HCV infection, affect the patient's care significantly, and might alter the course of the disease. A multidisciplinary approach, a supportive environment, and a nonjudgmental healthcare team are required for optimal medical and psychosocial management of patients with HCV.
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Affiliation(s)
- Amirhossein Modabbernia
- Digestive Disease Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
- Psychiatric Research Centre, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Hossein Poustchi
- Digestive Disease Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Reza Malekzadeh
- Digestive Disease Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
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Sleep, fatigue, and functional health in psychotic patients. SCHIZOPHRENIA RESEARCH AND TREATMENT 2013; 2013:425826. [PMID: 23738067 PMCID: PMC3659476 DOI: 10.1155/2013/425826] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 04/10/2013] [Indexed: 12/26/2022]
Abstract
This study sought to examine the association between sleep, fatigue, and functional health in psychotic patients. Participants included 93 psychotic inpatients (n = 67 with schizophrenia) who completed the Chalder Fatigue Scale (ChFS), the Fatigue Symptom Inventory (FSI), the Pittsburgh Sleep Quality Index (PSQI), and the SF36 Health Survey. Patients were classified on the basis of their performance on sleep and fatigue measures: 60% reported significant levels of fatigue and 67% significant sleep disturbances. 28.4% reported both, suggesting that fatigue and sleep dysfunctions do not necessarily cooccur. A closer examination of patterns showed that fatigue was only related to qualitative aspects of sleep and not quantifiable aspects of sleep disturbances. The results also showed that functional health was the lowest in patients with high levels of fatigue, compared to patients with sleep problems only or patients with neither symptom. A regression analysis further showed that the size of the contribution of fatigue onto functional health was twice as much as that of sleep dysfunctions. In conclusion, the results show that (i) dissatisfaction with sleep-and not sleep itself-is related to fatigue symptoms and that (ii) fatigue is particularly detrimental to functional health, regardless of the presence of sleep dysfunctions.
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11
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Tetè S, Varvara G, Murmura G, Saggini A, Maccauro G, Rosati M, Cianchetti E, Tripodi D, Toniato E, Fulcheri M, Caraffa A, Antinolfi P, Pandolfi F, Potalivo G, Conti P, Theoharides T. Impact of Immunity in Autism Spectrum Disorders. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Autism spectrum disorders (ASDs) are childhood psychopathologies characterized by having difficulties in social interaction, verbal and non-verbal communication as well as sensor motor movements. Evidence suggests that in ASDs environmental toxicant exposure, genetic and mitochondrial dysfunction are involved associated with abnormal immune response with allergic problems and elevated serum IgE. ASDs present the major cytokine and chemokine dysfunction in CNS and is mediated by an increase of pro-inflammatory cytokine levels in the brain, such as TNF, IL-1, IFN-γ, IL-6, IL-8 and others. Mast cells, which are also implicated in ASDs, are worsened by stress and produce proinflammatory cytokines and can be stimulated by neurotensin in the brain and gut, contributing also to the inflammatory response. However, the exact etiology of ASDs remains largely unknown.
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Affiliation(s)
- S. Tetè
- Dental School, University of Chiet-Pescarai, Chieti, Italy
| | - G. Varvara
- Dental School, University of Chiet-Pescarai, Chieti, Italy
| | - G. Murmura
- Dental School, University of Chiet-Pescarai, Chieti, Italy
| | - A. Saggini
- Dermatology Department, University Tor Vergata, Rome, Italy
| | - G. Maccauro
- Orthopedics Division, Università Cattolica, Rome, Italy
| | - M. Rosati
- Gynecology Division, Pescara Hospital, Italy
| | - E. Cianchetti
- Department of Surgery, Ortona ASL Hospital, Ortona, Italy
| | - D. Tripodi
- Dental School, University of Chiet-Pescarai, Chieti, Italy
| | - E. Toniato
- Immunology Division, Medical School, University of Chieti-Pescara, Italy
| | - M. Fulcheri
- Psychology School, University of Chieti-Pescara, Italy
| | - A. Caraffa
- Orthopeadics Division, University of Perugia, Italy
| | - P. Antinolfi
- Orthopeadics Division, University of Perugia, Italy
| | - F. Pandolfi
- Department of Medicine, Catholic University of Rome, Rome, Italy
| | - G. Potalivo
- Orthopeadics Division, University of Perugia, Italy
| | - P. Conti
- Immunology Division, Medical School, University of Chieti-Pescara, Italy
| | - T.C. Theoharides
- Internal Medicine and Biochemistry, Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine and Drug Discovery Laboratory, Tufts-New England Medical Center, Boston, MA, USA
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12
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Nicoletti M, Maccauro G, Tripodi D, Saggini A, Potalivo G, Castellani M, Conti F, Rosati M, Tomato E, Caraffa A, Antinolfi P, Conti P, Theoharides T. Impact of IL-33 on PGD2 Generation by Activated Human Cord Blood-Derived Mast Cell: Lack of Effect on Tryptase Release. EUR J INFLAMM 2012. [DOI: 10.1177/1721727x1201000323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Mast cells are important not only in allergic reactions, but also in inflammation and are involved in a variety of responses including the immediate release of potent inflammatory mediators after activation by cross-linking of FcεRI molecules. Prostaglandin D2 (PGD2) is a major cyclooxygenase metabolite of arachidonic acid produced by mast cells and it is released following allergen challenge in allergic diseases. IL-33 is an iflammatory cytokine which is critically involved in the regulation of in vitro and in vivo cyclooxygenase production, providing a potential therapeutic target for inflammatory disorders. In this study, using human derived umbelical cord blood mast cells, we show that IL-33 (50 ng/ml), and calcium ionophore A 23187 (0.5 μg/ml), compound 48/80 (10−5 M) or anti-IgE (10 μg/ml), enhaced the production of PGD2 and this effect was inhibited by indomethacin. However, IL-33 was unable to induce tryptase release in these cells. These effects confirm the inflammatory property of IL-33 by stimulating PGD2 but not tryptase in human mast cells. The inhibitory effect of this new cytokine may have a potential therapeutic response in allergic and inflammatory diseases.
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Affiliation(s)
- M. Nicoletti
- Department of Neurosciences and Imaging, University of Chieti, Italy
| | - G. Maccauro
- Orthopedics Division, Catholic University of Rome, Rome, Italy
| | - D. Tripodi
- Dental School, University of Chieti-Pescara, Chieti, Italy
| | - A. Saggini
- Dermatology Department, University Tor Vergata, Rome, Italy
| | - G. Potalivo
- Orthopedics Division, University of Perugia, Perugia, Italy
| | - M.L. Castellani
- Immunology Division, University of Chieti-Pescara, Chieti, Italy
| | - F. Conti
- Gynecology Division, “Santo Spirito” Hospital, Pescara, Italy
| | - M. Rosati
- Gynecology Division, “Santo Spirito” Hospital, Pescara, Italy
| | - E. Tomato
- Immunology Division, University of Chieti-Pescara, Chieti, Italy
| | - A. Caraffa
- Orthopedics Division, University of Perugia, Perugia, Italy
| | - P. Antinolfi
- Orthopedics Division, University of Perugia, Perugia, Italy
| | - P. Conti
- Immunology Division, University of Chieti-Pescara, Chieti, Italy
| | - T.C. Theoharides
- Department of Physiology and Pharmacology, Tufts University School of Medicine, New England Medical Center, Boston, MA, USA
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13
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Tetè S, Tripodi D, Rosati M, Conti F, Maccauro G, Saggini A, Salini V, Cianchetti E, Caraffa A, Antinolfi P, Toniato E, Castellani ML, Pandolfi F, Frydas S, Conti P, Theoharides TC. Endothelial cells, cholesterol, cytokines, and aging. Int J Immunopathol Pharmacol 2012; 25:355-63. [PMID: 22697067 DOI: 10.1177/039463201202500205] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
It has been reported that high levels of cholesterol and triglycerides are associated with increased risk of developing atherosclerosis and shorter life. In fact, vascular endothelial dysfunction occurs during the human aging process. Accumulation of lipids in vascular endothelium activates leukocytes to produce cytokines and chemokines which recruit macrophages. On the other hand, macrophages augment inflammatory response and secrete vascular endothelial growth factor, a key cytokine that mediates angiogenesis and inflammatory response. In addition, hyperlipidaemia is one of the main risk factors for aging, hypertension and diabetes. Here, we review the interrelationship between endothelial cells, high level of cholesterol, and aging.
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