How do people who use drugs receiving Opioid Medication Therapy perceive their treatment ? A multicentre study.

BACKGROUND: The resurgence of heroin use and the misuse of pharmaceutical opioids are some of the reasons for a worldwide increase in opioid dependence. Opioid Medication Therapies (OMT) have amply demonstrated their efficacy. From a medical point of view, the main objectives of OMT concern medical and social outcomes, centred on risk reduction and the cessation of opioid use. But patient points of view can differ and few studies have explored opioid-dependent patient viewpoints on their OMT. This variable seems important to consider in a patient-centred approach. The aim of our study was to explore points of view of people who use drugs (PWUD) treated with OMT, in a large multicentre sample. METHOD: A cross-sectional multicentre study explored the points of view of PWUD with Opioid Use Disorder following OMT. Data regarding the patients' points of view were collected using a self-administered questionnaire developed by the scientific committee of the study. A descriptive analysis and an exploratory factor analysis were performed to explore the structure of items exploring patient viewpoints. RESULTS: 263 opioid dependent PWUD were included, a majority were men consuming heroin prior to being prescribed OMT. 68% were on methadone, 32% were on buprenorphine. Most PWUD identified a positive impact on their lives, with 92.8% agreeing or strongly agreeing that OMT had changed a lot of things in their lives. The exploratory factor analysis identified three factors: (F1) items related to points of views concerning the objectives and efficacy of OMT; (F2) items related to the legitimacy of OMT as a treatment compared to a drug, (F3) items related to experiences and relationships with OMT. CONCLUSION: Patient viewpoints on efficacy were correlated with the pharmacological benefits of OMT and with the associated psychosocial measures. The implications of OMT in relationships, such as the feeling of being judged, concerned a majority. Points of view were ambivalent concerning the role of OMT as a treatment or as a drug. Involving patient points of view in therapeutic strategies decisions could help enhance positive views among PWUD on OMT and help PWUD towards their recovery. TRIAL REGISTRATION: OPAL study was registered: (NCT01847729).

Evaluation of cognitive impairment in a French sample of patients with restrictive anorexia nervosa: two distinct profiles emerged with differences in impaired functions and psychopathological symptoms.

PURPOSE: The cognitive profiles of patients suffering from anorexia nervosa (AN) are currently explored as potential facilitating and/or maintenance factors. Specific data in restrictive AN (AN-R) remain contradictory. This study focused on women with AN-R to evaluate their cognitive functions to develop a more specific cognitive remediation program. METHODS: Female patients older than 15 years who were suffering from AN-R were recruited in a specialized unit for eating disorder management. Female healthy control (HC) participants were recruited who were matched with AN patients on age. All participants completed a cognitive evaluation (premorbid intelligence quotient (IQ), planning, information processing speed, cognitive flexibility) and a clinical evaluation (impulsivity, anxiety, depression). RESULTS: A total of 122 participants were included. Patients suffering from AN-R had significant impairment in information processing speed and planning. Patients exhibited significantly better cognitive flexibility than did the HC group when adjustments were made for other cognitive functions and impulsivity. Two distinct subgroups of patients were identified. The first subgroup had more marked cognitive impairment and fewer psychopathological symptoms than did the second subgroup of patients and the HC group. CONCLUSION: Our results highlight cognitive impairment in patients with AN who had normal premorbid IQ. Two distinct profiles emerge. In clinical practice, these results open up perspectives for the development of more specific cognitive remediation programs (one specific program for cold cognitions and another specific program targeting emotions and hot cognitions). These results warrant confirmation by larger studies with a more specific evaluation of the impact of emotional status. Trial registration NTC02381639, Date of registration. March 6, 2015.

The level and source of free-methionine affect body composition and breast muscle traits in growing broilers.

Although dietary Met, as the first limiting amino acid (AA), has been extensively studied for poultry, little is known about how the supply and source of free Met affect tissue composition. The purpose of this study was to investigate the effect of feeding young broiler chickens with a deficient or sufficient TSAA (Met+Cys) supply, using either dl-Met (dl-Met+ and dl-Met-, for respectively diets sufficient and deficient in TSAA) or dl-2-hydroxy-4-methylthiobutyric acid (HMTBA+ and HMTBA-, for respectively diets sufficient and deficient in TSAA) as a Met source on tissue composition and breast muscle traits. For both Met sources, the deficient diets were formulated to provide true digestible Met:Lys and TSAA:Lys respectively 45% and 30% below that of the sufficient diets. Performance and tissue weights were affected by the Met supply but not by the Met source. In TSAA-deficient chickens, ADG and FCR, and protein content in empty body and pectoralis major muscles (PM) were lower than in TSAA-sufficient chickens (P < 0.05). Reducing the Met content of the diet increased the redness value of PM (a*) and the hue angle (H°; P < 0.01). The source of Met affected body AA composition and the partitioning of body Cys among tissues (P < 0.05). In TSAA-deficient birds, body Cys mass decreased in the commercial carcass and PM, but increased in the rest of the body (P < 0.01). The Met source also had an impact on the Cys mass, which was reduced in the commercial carcass and PM of dl-Met birds, but higher in the rest, especially in the feathers of TSAA-deficient birds (P < 0.05). The Met source, supply, or both altered the AA composition of the empty body, mostly in the commercial carcass. In conclusion, a dietary TSAA deficiency altered performance, tissue composition and quality traits of PM of broilers. There was no impact between dietary dl-Met and dl-HMTBA on performance or muscle weight, although the Met source affected the partitioning of Cys among tissues.