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Chronic fatigue treatment

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https://www.readbyqxmd.com/read/28818546/glecaprevir-plus-pibrentasvir-for-chronic-hepatitis-c-virus-genotype-1-2-4-5-or-6-infection-in-adults-with-compensated-cirrhosis-expedition-1-a-single-arm-open-label-multicentre-phase-3-trial
#1
Xavier Forns, Samuel S Lee, Joaquin Valdes, Sabela Lens, Reem Ghalib, Humberto Aguilar, Franco Felizarta, Tarek Hassanein, Holger Hinrichsen, Diego Rincon, Rosa Morillas, Stefan Zeuzem, Yves Horsmans, David R Nelson, Yao Yu, Preethi Krishnan, Chih-Wei Lin, Jens J Kort, Federico J Mensa
BACKGROUND: The once-daily, ribavirin-free, pangenotypic, direct-acting antiviral regimen, glecaprevir coformulated with pibrentasvir, has shown high rates of sustained virological response in phase 2 and 3 studies. We aimed to assess the efficacy and safety of 12 weeks of coformulated glecaprevir and pibrentasvir in patients with hepatitis C virus (HCV) infection and compensated cirrhosis. METHODS: We did this single-arm, open-label, multicentre phase 3 study at 40 sites in Belgium, Canada, Germany, South Africa, Spain, and the USA...
August 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28816983/characteristics-of-turkish-patients-with-elderly-onset-psoriatic-arthritis-a-retrospective-cohort-study
#2
Senol Kobak, Fidan Yildiz, Ahmet Karaarslan, Huseyin Semiz, Mehmet Orman
Psoriatic arthritis (PsA) is a chronic inflamatory disease characterized with axial and peripheral joints involvement. It rarely affects patients older than 65 years old.The purpose of this study is to compare and evaluate the demographic, clinical and laboratory features of elderly-onset psoriatic arthritis (EOPsA) and young-onset (YOPsA) patients.A total of 180 patients diagnosed with PsA according to CASPAR criteria and followed-up in single center were included in this study. The patients with initial symptoms started after age 65 were accepted as EOPsA...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28810460/exploring-our-understanding-of-fatigue-among-adolescents-living-with-hiv-highlighting-the-unknown
#3
Maria Elizabeth Loades, Ashraf Kagee
Due to antiretroviral therapies, HIV is now a chronic illness rather than a terminal disease. Chronic symptoms, including fatigue, should be identified and managed to prevent or minimise their potential negative consequences. We apply a Symptom Management Model to conceptualise fatigue among adolescents with HIV. In the context of minimal research, we seek to identify a research agenda for resource-constrained contexts, where HIV prevalence remains high and treatment adherence is a significant problem. By better understanding and addressing the symptom of fatigue, treatment adherence, occupational, social and emotional functioning could be improved...
May 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28809936/benefits-and-safety-of-gabapentinoids-in-chronic-low-back-pain-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Harsha Shanthanna, Ian Gilron, Manikandan Rajarathinam, Rizq AlAmri, Sriganesh Kamath, Lehana Thabane, Philip J Devereaux, Mohit Bhandari
BACKGROUND AND OBJECTIVE: Chronic Low Back Pain (CLBP) is very common, with a lifetime prevalence between 51% and 80%. In majority, it is nonspecific in nature and multifactorial in etiology. Pregabalin (PG) and Gabapentin (GB) are gabapentinoids that have demonstrated benefit in neuropathic pain conditions. Despite no clear rationale, they are increasingly used for nonspecific CLBP. They necessitate prolonged use and are associated with adverse effects and increased cost. Recent guidelines from the National Health Service (NHS), England, expressed concerns on their off-label use, in addition to the risk of misuse...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28806608/differential-effects-of-childhood-trauma-subtypes-on-fatigue-and-physical-functioning-in-chronic-fatigue-syndrome
#5
Maud De Venter, Jela Illegems, Rita Van Royen, Greta Moorkens, Bernard G C Sabbe, Filip Van Den Eede
OBJECTIVE: There is wide consensus that childhood trauma plays an important role in the aetiology of chronic fatigue syndrome (CFS). The current study examines the differential effects of childhood trauma subtypes on fatigue and physical functioning in individuals suffering from CFS. METHODS: Participants were 155 well-documented adult, predominantly female CFS patients receiving treatment at the outpatient treatment centre for CFS of the Antwerp University Hospital in Belgium...
July 19, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28805529/cognitive-behaviour-therapy-and-objective-assessments-in-chronic-fatigue-syndrome
#6
Graham McPhee
Most evaluations of cognitive behavioural therapy to treat people with chronic fatigue syndrome/myalgic encephalomyelitis rely exclusively on subjective self-report outcomes to evaluate whether treatment is effective. Few studies have used measures appropriate to assessing whether cognitive behavioural therapy changes in more objective measures. A review of studies incorporating objective measures suggests that there is a lack of evidence that cognitive behavioural therapy produces any improvement in a patient's physical capabilities or other objective measures such as return to work...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805527/bias-misleading-information-and-lack-of-respect-for-alternative-views-have-distorted-perceptions-of-myalgic-encephalomyelitis-chronic-fatigue-syndrome-and-its-treatment
#7
Ellen Goudsmit, Sandra Howes
The PACE trial is one of the most recent studies evaluating cognitive behavioural therapy and graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome. These interventions are based on a model which assumes that symptoms are perpetuated by factors such as misguided beliefs and a lack of activity. Our analysis indicates that the researchers have shown significant bias in their accounts of the literature and may also have overstated the effectiveness of the above treatments. We submit that their approach to criticisms undermines the scientific process and is inconsistent with best practice...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805526/the-problem-of-bias-in-behavioural-intervention-studies-lessons-from-the-pace-trial
#8
Carolyn Wilshire
Geraghty's recent editorial on the PACE trial for chronic fatigue syndrome has stimulated a lively discussion. Here, I consider whether the published claims are justified by the data. I also discuss wider issues concerning trial procedures, researcher allegiance and participant reporting bias. Cognitive behavioural therapy and graded exercise therapy had modest, time-limited effects on self-report measures, but little effect on more objective measures such as fitness and employment status. Given that the trial was non-blinded, and the favoured treatments were promoted to participants as 'highly effective', these effects may reflect participant response bias...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805525/pace-gate-an-alternative-view-on-a-study-with-a-poor-trial-protocol
#9
Bart Stouten
The controversies surrounding the effectiveness of cognitive behavioural therapy and graded exercise therapy for chronic fatigue syndrome are explained using Cohen's d effect sizes rather than arbitrary thresholds for 'success'. This article shows that the treatment effects vanish when switching to objective outcomes. The preference for subjective outcomes by the PACE trial team leads to false hope. This article provides a more realistic view, which will help patients and their doctors to evaluate the pros and cons...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805524/response-to-the-editorial-by-dr-geraghty
#10
Peter D White, Trudie Chalder, Michael Sharpe, Brian J Angus, Hannah L Baber, Jessica Bavinton, Mary Burgess, Lucy V Clark, Diane L Cox, Julia C DeCesare, Kimberley A Goldsmith, Anthony L Johnson, Paul McCrone, Gabrielle Murphy, Maurice Murphy, Hazel O'Dowd, Laura Potts, Rebacca Walwyn, David Wilks
This article is written in response to the linked editorial by Dr Geraghty about the adaptive Pacing, graded Activity and Cognitive behaviour therapy; a randomised Evaluation (PACE) trial, which we led, implemented and published. The PACE trial compared four treatments for people diagnosed with chronic fatigue syndrome. All participants in the trial received specialist medical care. The trial found that adding cognitive behaviour therapy or graded exercise therapy to specialist medical care was as safe as, and more effective than, adding adaptive pacing therapy or specialist medical care alone...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805523/the-pace-trial-it-s-time-to-broaden-perceptions-and-move-on
#11
Keith J Petrie, John Weinman
The continued critiques of the PACE trial highlight how differing beliefs about the causes of chronic fatigue syndrome still influence how scientific studies in this area are accepted and evaluated. Causal beliefs about chronic fatigue syndrome and a modern version of Cartesian dualism are important in understanding the reaction to the PACE trial. The continued debate on the PACE trial seems to miss the fact that science is incremental. An unfortunate outcome of the PACE controversy and intimidation of researchers may be less research in the area...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805522/pace-trial-claims-for-recovery-in-myalgic-encephalomyelitis-chronic-fatigue-syndrome-true-or-false-it-s-time-for-an-independent-review-of-the-methodology-and-results
#12
Charles Bernard Shepherd
The PACE trial set out to discover whether cognitive behaviour therapy and graded exercise therapy are safe and effective forms of treatment for myalgic encephalomyelitis/chronic fatigue syndrome. It concluded that these interventions could even result in recovery. However, patient evidence has repeatedly found that cognitive behaviour therapy is ineffective and graded exercise therapy can make the condition worse. The PACE trial methodology has been heavily criticised by clinicians, academics and patients...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805460/case-study-of-homeopathic-bowel-nosode-remedies-for-dysbiotic-japanese-patients
#13
Yoko Uchiyama-Tanaka
BACKGROUND: The composition of intestinal microbiota is very important in human health. Gastrointestinal disturbances are among the symptoms commonly reported by individuals diagnosed with chronic diseases, such as inflammatory bowel disease, autism, and chronic fatigue syndrome. The effects of probiotics and prebiotics for dysbiosis have been reported in many studies. Bowel nosodes are homeopathic remedies made from human gut microbiota. OBJECTIVE: Bowel nosodes made from the intestinal bacteria of European patients from the 1900s were administered to Japanese patients suffering from gastrointestinal disturbances, such as constipation and diarrhea, to determine their therapeutic efficacy...
August 14, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28802816/safety-and-efficacy-of-an-8-week-regimen-of-grazoprevir-plus-ruzasvir-plus-uprifosbuvir-compared-with-grazoprevir-plus-elbasvir-plus-uprifosbuvir-in-participants-without-cirrhosis-infected-with-hepatitis-c-virus-genotypes-1-2-or-3-c-crest-1-and-c-crest-2-part
#14
Edward J Gane, Stephen Pianko, Stuart K Roberts, Alexander J Thompson, Stefan Zeuzem, Eli Zuckerman, Ziv Ben-Ari, Graham R Foster, Kosh Agarwal, Alex L Laursen, Jan Gerstoft, Wei Gao, Hsueh-Cheng Huang, Brian Fitzgerald, Doreen Fernsler, Jerry J Li, Anjana Grandhi, Hong Liu, Feng-Hsiu Su, Shuyan Wan, Zhen Zeng, Huei-Ling Chen, Frank J Dutko, Bach-Yen T Nguyen, Janice Wahl, Michael N Robertson, Eliav Barr, Wendy W Yeh, Rebeca M Plank, Joan R Butterton, Rafael Esteban
BACKGROUND: New hepatitis C virus (HCV) therapies with pan-genotypic efficacy are needed. The goals of part A of C-CREST-1 and C-CREST-2 were to compare the efficacies of two doses (300 mg or 450 mg once daily) of uprifosbuvir (MK-3682; NS5B inhibitor) in an 8-week regimen combined with grazoprevir (NS3/4A inhibitor; 100 mg once daily) and an NS5A inhibitor, either elbasvir (50 mg once daily) or ruzasvir (MK-8408; 60 mg once daily), and to evaluate the safety and tolerability of these combination regimens in individuals infected with genotypes 1, 2, or 3...
August 9, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28802814/safety-and-efficacy-of-a-fixed-dose-combination-regimen-of-grazoprevir-ruzasvir-and-uprifosbuvir-with-or-without-ribavirin-in-participants-with-and-without-cirrhosis-with-chronic-hepatitis-c-virus-genotype-1-2-or-3-infection-c-crest-1-and-c-crest-2-part-b-two
#15
Eric Lawitz, Maria Buti, John M Vierling, Piero L Almasio, Savino Bruno, Peter J Ruane, Tarek I Hassanein, Beat Muellhaupt, Brian Pearlman, Ligita Jancoriene, Wei Gao, Hsueh-Cheng Huang, Aimee Shepherd, Brynne Tannenbaum, Doreen Fernsler, Jerry J Li, Anjana Grandhi, Hong Liu, Feng-Hsiu Su, Shuyan Wan, Frank J Dutko, Bach-Yen T Nguyen, Janice Wahl, Michael N Robertson, Eliav Barr, Wendy W Yeh, Rebeca M Plank, Joan R Butterton, Eric M Yoshida
BACKGROUND: There is a need for hepatitis C virus (HCV) therapies with excellent efficacy across genotypes and in diverse populations. Part A of the C-CREST-1 and C-CREST-2 trials led to the selection of a three-drug regimen of grazoprevir (MK-5172; an HCV NS3/4A protease inhibitor; 100 mg/day) plus ruzasvir (MK-8408; an NS5A inhibitor; 60 mg/day) plus uprifosbuvir (MK-3682; an HCV NS5B polymerase inhibitor; 450 mg/day). Part B of the studies tested this combination as a single formulation in different treatment durations in a broader population...
August 9, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28802475/integrative-pain-management
#16
REVIEW
Robert Alan Bonakdar
Chronic pain is one of the most common conditions seen in the clinic, and it is often one of the most frustrating for both clinicians and patients. This condition stems from common comorbidities, including depression, insomnia, fatigue, and physical deconditioning, which often create barriers to recovery. In addition, chronic pain has had divergent approaches for treatment, including an overemphasis on analgesia and curative treatments while underemphasizing the biopsychosocial needs of those in pain. This article attempts to provide an initial framework for approaching those in pain and initiating patient-centered options to support improvements in pain, function, and self-care...
September 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28798049/patient-reported-outcomes-from-a-phase-3-study-of-baricitinib-versus-placebo-or-adalimumab-in-rheumatoid-arthritis-secondary-analyses-from-the-ra-beam-study
#17
Edward C Keystone, Peter C Taylor, Yoshiya Tanaka, Carol Gaich, Amy M DeLozier, Anna Dudek, Jorge Velasco Zamora, Jose Arturo Covarrubias Cobos, Terence Rooney, Stephanie de Bono, Vipin Arora, Bruno Linetzky, Michael E Weinblatt
BACKGROUND: To assess the effect of baricitinib on patient-reported outcomes (PROs) in patients with active rheumatoid arthritis and an inadequate response to methotrexate (MTX). METHODS: In this double-blind phase 3 study, patients were randomised 3:3:2 to placebo (n=488), baricitinib 4 mg once daily (n=487), or adalimumab 40 mg biweekly (n=330) with background MTX. PROs included the SF-36, EuroQol 5-D (EQ-5D) index scores and visual analogue scale, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient's Global Assessment of Disease Activity (PtGA), patient's assessment of pain and Work Productivity and Activity Impairment Questionnaire-Rheumatoid Arthritis (WPAI-RA), and measures collected in electronic patient daily diaries: duration and severity of morning joint stiffness (MJS), Worst Ttiredness and Worst Joint Pain...
August 10, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28771870/the-perception-and-attention-functions-test-battery-as-a-measure-of-neurocognitive-impairment-in-patients-with-suspected-central-disorders-of-hypersomnolence
#18
Markus Ramm, Arsalan Jafarpour, Matthias Boentert, Nelly Lojewsky, Peter Young, Anna Heidbreder
The aim of the current study was to evaluate an attention test as a discriminative tool to measure neurocognitive impairment in patients with disorders of hypersomnolence. Chronic excessive daytime sleepiness is the main symptom in central disorders of hypersomnolence. For diagnostic purposes and treatment evaluation, reliable assessment of excessive daytime sleepiness is required. Thirty-six patients with central disorders of hypersomnolence were compared with 20 healthy controls. All participants performed the 'Perception and Attention Functions' (WAF) of the Vienna Test System...
August 2, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28769135/fatigue-an-underestimated-symptom-in-psoriatic-arthritis
#19
REVIEW
Magdalena Krajewska-Włodarczyk, Agnieszka Owczarczyk-Saczonek, Waldemar Placek
The nature of fatigue is very complex and involves physiological, psychological and social phenomena at the same time, and the mechanisms leading to occurrence and severity of fatigue are still poorly understood. The condition of chronic inflammation associated with psoriatic arthritis can be regarded as a potential factor affecting development of fatigue. Only a few studies so far have focused on the occurrence of fatigue in psoriatic arthritis. The problem of chronic fatigue is underestimated in everyday clinical practice...
2017: Reumatologia
https://www.readbyqxmd.com/read/28766982/serum-met-5-enkephalin-levels-are-reduced-in-multiple-sclerosis-and-restored-by-low-dose-naltrexone
#20
Michael D Ludwig, Ian S Zagon, Patricia J McLaughlin
Low-dose naltrexone is a widely used off-label therapeutic prescribed for a variety of immune-related disorders. The mechanism underlying low-dose naltrexone's efficacy for fatigue, Crohn's disease, fibromyalgia, and multiple sclerosis is, in part, intermittent blockade of opioid receptors followed by upregulation of endogenous opioids. Short, intermittent blockade by naltrexone specifically blocks the opioid growth factor receptor resulting in biofeedback events that increase production of the endogenous opioid growth factor (OGF) (chemically termed [Met(5)]-enkephalin) facilitating interactions between opioid growth factor and opioid growth factor receptor that ultimately, result in inhibited cell proliferation...
January 1, 2017: Experimental Biology and Medicine
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