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[This corrects the article DOI: 10.1371/journal.pone.0208112.].
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BACKGROUND: Fatigue is a common symptom in patients with inflammatory bowel disease (IBD), and it often persists despite clinical remission. Acupuncture has been shown to be effective for treating fatigue in patients with many chronic diseases. The main objective of the study was to assess the efficacy of electroacupuncture (EAc), compared with sham EAc (ShEAc) or being on a waitlist (WL), for treating fatigue in patients with quiescent IBD in a single-blind randomized trial. METHODS: Fifty-two patients with IBD in clinical remission and fatigue were randomly assigned to 1 of 3 groups: EAc, ShEAc, or WL. Patients in the EAc and ShEAc groups received 9 sessions over 8 weeks. Fatigue was evaluated with the IBD-validated Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-FS). RESULTS: Baseline characteristics were similar in the 3 groups. Both EAc and ShEAc presented improved Functional Assessment of Chronic Illness Therapy-Fatigue Scale scores compared with baseline: the respective improvements were 9.53 (95% confidence intervals, 6.75-12.3, P < 0.001) and 5.46 points (95% confidence intervals, 2.7-9.7, P = 0.015), respectively. No significant changes were observed in the WL group. In the comparison of treatment groups, EAc was nonsignificantly better than ShEAc (EAc, 33.27 and ShEAc, 28.13, P = 0.168); both EAc and ShEAc improved fatigue scores significantly compared to WL (24.5; P = 0.01 and 0.04, respectively). CONCLUSIONS: Both EAc and ShEAc reduced fatigue scores in IBD patients when compared to WL. No differences were observed between EAc and ShEAc, although the study was not powered to rule out a difference. Acupuncture may offer improvements to patients with few other treatment alternatives. Clinical Trials Org Id: NCT02733276.
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Electroacupuntura/métodos , Fatiga/fisiopatología , Fatiga/terapia , Enfermedades Inflamatorias del Intestino/diagnóstico , Adulto , Estudios Cruzados , Electroacupuntura/efectos adversos , Femenino , Humanos , Enfermedades Inflamatorias del Intestino/fisiopatología , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Calidad de Vida , Índice de Severidad de la Enfermedad , Método Simple CiegoRESUMEN
BACKGROUND AND AIM: Treatment of hepatitis C with direct-acting antiviral agents (DAA) has few side effects. Although pivotal studies suggested that DAA were safe in patients with psychiatric diseases who could not be treated with previous antiviral therapies, their effects on anxiety and depression have not yet been analysed in clinical practice. The aim of our study was to analyse anxiety and depression in the setting of DAA treatment in a clinical practice series. METHODS: All patients starting DAA treatment between November 1, 2014 and October 31, 2015 were eligible. Patients completed the Hospital Anxiety and Depression scale at different times during treatment. The results were plotted on line graphs and evaluated using a linear regression model with repeated measures. RESULTS: One hundred and forty-five patients were included (11% with major psychiatric disorders; 32% on psychiatric treatment). Sustained virologic response (SVR) was achieved in 97.3% of cases. Anxiety and depression measures did not differ between time points. No differences between patients on psychiatric treatment or with advanced fibrosis or cirrhosis were found at any time point analysed. CONCLUSION: DAA treatment had no impact on anxiety or depression during or after chronic hepatitis C infection treatment, even in high-risk patients with major psychiatric disorders.
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Antivirales/efectos adversos , Ansiedad/epidemiología , Depresión/epidemiología , Hepatitis C Crónica/tratamiento farmacológico , Trastornos Mentales/epidemiología , Anciano , Antivirales/administración & dosificación , Ansiedad/inducido químicamente , Ansiedad/diagnóstico , Comorbilidad , Depresión/inducido químicamente , Depresión/diagnóstico , Femenino , Hepacivirus/efectos de los fármacos , Hepacivirus/aislamiento & purificación , Hepatitis C Crónica/epidemiología , Hepatitis C Crónica/psicología , Hepatitis C Crónica/virología , Humanos , Masculino , Persona de Mediana Edad , Cuestionario de Salud del Paciente/estadística & datos numéricos , Estudios Prospectivos , Respuesta Virológica SostenidaRESUMEN
The treatment of chronic hepatitis C with direct action antivirals has led to a radical change in the management of patients. The elderly or people with morbidities, for whom it was previously contraindicated, are currently candidates for this treatment due to its being well tolerated and safe. The nursing visit at the beginning of treatment is essential to reinforce adherence, to educate on the management of adverse effects, to resolve doubts and to emphasise the importance of pharmacological interactions, in order to promote correct therapeutic compliance. However, due to the new communication tools, it is possible to convey healthcare services without requiring the physical presence of the patient in the medical centre. The telephone has become a routine and indispensable work tool for the nursing professional. This paper describes the pilot test that was performed with 38 patients, previously selected, whose nursing visit at the beginning of treatment was by telephone instead of face-to-face, in order to evaluate the implementation of the telephone nurse consultation, for patients who started treatment with direct antivirals for the hepatitis C virus.