Plasma carnitine is associated with fatigue in chronic hepatitis C but not in irritable bowel syndrome : Carnitine and fatigue in hepatitis C

International audienceObjectives Fatigue is an important determinant of altered quality of life in patients affected by chronic hepatitis C (CHC) or the irritable bowel syndrome (IBS). In this study, we aimed at determining the contributory role of plasma levels of leptin and carnitine on fatigue in CHC and IBS. Methods We enrolled 70 patients with CHC, 42 with IBS and 44 healthy subjects. Fatigue was evaluated using the Fatigue Impact Scale questionnaire. Body composition was assessed through impedance analysis. Plasma carnitine and leptin were measured. Results Fatigue scores were significantly more elevated in patients with CHC and IBS than in healthy subjects. Patients with CHC, but not with IBS, had significant lower plasma levels of total and free carnitine adjusted for fat mass compared to healthy subjects. In patients with CHC, and not with IBS, fatigue scores were negatively correlated with plasma levels of carnitine. Levels of free carnitine were significantly and independently associated with the severity of fatigue in patients with CHC (OR=2.019, p=0.02, CI 95% [1.01-1.23]).Conclusions In patients with CHC, the severity of fatigue is associated with low level of carnitine, suggesting that an oral supplementation may be effective to relieve fatigue in CHC. The underlying mechanism of fatigue in IBS does not seem to involve carnitine

Intérêt du questionnaire Everest (2011) dans le dépistage des facteurs de stress au travail

NICE-BU Médecine Odontologie (060882102) / SudocSudocFranceF

A call for mindfulness-based interventions for cannabis-use disorders

Cannabis use is being increasingly liberalized worldwide, and an increasing prevalence of cannabis-use disorder (CUD) is observed. The few current therapeutic options for CUD are only modestly effective. Mindfulness-based interventions offer promising prospects for the management of substance-use disorders. However, despite proliferating literature on mindfulness and substance use, few studies have explored mindfulness in terms of cannabis use and CUD. There are many possibilities for the implementation of mindfulness-based interventions for cannabis use reduction, especially for younger users, who are more vulnerable to cannabis-related harms. Accordingly, large controlled trials are needed to reliably assess the potential of such interventions

COVID-19 pandemic: a European perspective on health economic policies

International audienceIn this contribution, delivered after more than one month of nationwide lockdowns of European countries, we discuss side-effects of the COVID-19 pandemic on citizens' access to medical care and the efficiency of national health systems in care provision. In the first section, we stress the importance of indirect mortality, i.e. non-diagnosis of non-COVID diseases whose standard-of-care management could have avoided death during the pandemic. We highlight how indirect mortality is linked to patients' psychological attitudes and behavioral responses to the unforeseen contingencies that the spread of COVID-19 has brought with it. The second section complements the first one by delving into the issue of the sustainability of financing and organization of national hospital systems, framing the discussion within the financial problems that the European Community is facing, which have been exacerbated by the current COVID-19 infection spread. Our interdisciplinary approach combines insights from academic surgery and psychiatry on the one side and behavioral and political economy on the other side

Gender differences in the impact of COVID-19 lockdown on potentially addictive behaviors. An emotion-mediated analysis

We study the impact of the spring 2020 lockdown in France on gender-related potentially addictive behaviors and associated negative emotions. We rely on an online survey we administered 1 week after the beginning of the lockdown, with responses collected within 2 weeks after the beginning of the lockdown (N = 1,087). We focus on potential addictions to non-creative activities as food consumption and smartphone usage (female-related), and videogame play (male-related). We find that women were about 1.6 times more likely than men to losing control of their usual diet and about 2.3 times more likely than men to increase smartphone usage, while no significant gender effect is detected as for increased videogame play. This is since the negative emotions driving the increase of female-related non-creative activities (sadness, discouragement, and nervousness) were themselves female-related, while the negative emotions driving the increase of male-related non-creative activities (boredom, emptiness, and stress) were shared by women too. Our study supports the intuition that the same negative emotion induced by COVID-19 side-effects could lead to different potentially addictive behaviors; this difference is explained by the interplay between different gender’s sensitivities to such emotion and different gender’s preferences for specific non-creative activities

COVID-19 pandemic: a European perspective on health economic policies

International audienceIn this contribution, delivered after more than one month of nationwide lockdowns of European countries, we discuss side-effects of the COVID-19 pandemic on citizens' access to medical care and the efficiency of national health systems in care provision. In the first section, we stress the importance of indirect mortality, i.e. non-diagnosis of non-COVID diseases whose standard-of-care management could have avoided death during the pandemic. We highlight how indirect mortality is linked to patients' psychological attitudes and behavioral responses to the unforeseen contingencies that the spread of COVID-19 has brought with it. The second section complements the first one by delving into the issue of the sustainability of financing and organization of national hospital systems, framing the discussion within the financial problems that the European Community is facing, which have been exacerbated by the current COVID-19 infection spread. Our interdisciplinary approach combines insights from academic surgery and psychiatry on the one side and behavioral and political economy on the other side

Behavioral Food Addiction During Lockdown: Time for Awareness, Time to Prepare the Aftermath

International audienc

Iatrogenic triggers for anorexia nervosa and bulimia nervosa: A WHO safety database disproportionality analysis

International audienceEating disorders, characterized by abnormal eating, weight control behaviors or both include anorexia nervosa (AN) and bulimia nervosa (BN). We investigated their potential iatrogenic triggers, using real-world data from the WHO safety database (VigiBase®). VigiBase® was queried for all AN and BN reports. The reports were classified as `pediatric' or `adult' according to age. Disproportionality analyses relied on the Information Component (IC), in which a 95% confidence interval lower-end positivity was required to suspect a signal. Our queries yielded 309 AN and 499 BN reports. Isotretinoin was disproportionately reported in pediatric AN (IC 3.6; [2.6-4.3]), adult AN (IC 3.1; [1.7-4.0]), and pediatric BN (IC 3.9; [3.0-4.7]). Lamivudine (IC 4.2; [3.2-4.9]), nevirapine (IC 3.7; [2.6-4.6]), and zidovudine (IC 3.4; [2.0-4.3]) had the highest ICs in adult AN. AN was associated with isotretinoin, anticonvulsants in minors, and antiretroviral drugs in adults. In adults, BN was related to psychotropic and hormonally active drugs. Before treatment initiation, an anamnesis should seek out mental health conditions, allowing the identification of patients at risk of developing or relapsing into AN or BN. In addition to misuse, the hypothesis of iatrogenic triggers for AN and BN should also be considered

Mindfulness as a Protective Factor Against Increased Tobacco and Alcohol Use in Hospital Workers Following the First COVID-19-Related Lockdown: a Study in Southern France

International audienceCOVID-19-related national lockdowns worldwide have had repercussions on people’s well-being and have led to increased substance use. Mindfulness has previously been associated with reduced psychological distress and benefits in terms of addictive behaviors. We aimed to assess whether dispositional mindfulness protected against increased tobacco and alcohol use in hospital workers after France’s first lockdown started. All workers in two French hospitals were contacted by email to participate in an online survey. Three hundred eighty-five workers answered. We ran two separate logistic regression models to test for associations between the level of dispositional mindfulness and both increased tobacco and alcohol use, after adjusting for affect deterioration. Dispositional mindfulness was associated with a lower likelihood of increased tobacco (adjusted odds ratio (AOR) [95% CI] 0.71 [0.51; 0.99], p = 0.046) and alcohol (0.66 [0.50; 0.87], p = 0.004) use. The effect of mindfulness on tobacco use was partially mediated by affect deterioration. Dispositional mindfulness appeared to be a protective factor against lockdown-related tobacco and alcohol use increases in French hospital workers