Health related quality of life among patients with chronic hepatitis C: a cross-sectional study of sociodemographic, psychopathological and psychiatric determinants

AbstractIntroductionChronic hepatitis C virus infection patients have higher rates of psychiatric disorders than the general population. Chronic hepatitis C virus infection is known to be associated with impaired health related quality of life. To our knowledge, there is no previous research of health related quality of life in chronic hepatitis C patients that combined structured psychiatric interview and careful psychopathological evaluation, including depression, anxiety and fatigue instruments. The aim of this study was to evaluate health related quality of life of chronic hepatitis C patients and to investigate the association with sociodemographic, psychopathological and psychiatric factors.Materials and methodsEighty-one individuals with chronic hepatitis C virus infection receiving care at a Brazilian public university-based outpatient service for infectious diseases were enrolled in the study. The World Health Organization Quality of Life Scale Brief Version was used to assess health related quality of life. Standard psychiatric interview (Mini International Neuropsychiatric Interview-Plus) was conducted to establish Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I psychiatric diagnosis. Further instruments completed psychopathological investigation: Beck Depression Inventory, Hospital Anxiety and Depression Scale, Brief Fatigue Inventory, Hamilton Depression Scale and Hamilton Anxiety Scale. Pearson Chi-Square and Kruskal–Wallis were performed for categorical and continuous univariate analysis, respectively. Correlation between psychopathological and health related quality of life scores was performed according to Spearman's correlation. Multivariate analysis was performed according to stepwise forward ordinal logistic regression. The significance threshold was fixed at α=0.05.ResultsDepressive disorders were associated with worse scores in overall health related quality of life and in all domains. Fatigue was associated with lower scores in physical and psychological domains, and married status with higher scores in psychological health related quality of life. We found strong correlation among scores of depression, fatigue and health related quality of life.ConclusionDepression and fatigue must be properly investigated and managed in HCV patients in order to improve HRQL. WHOQOL-BREF proved to be a useful instrument to assess HRQL in HCV patients

Deficiência de vitamina B12 e transtorno depressivo refratário

A vitamina B12, ou cianocobalamina, desempenha importantes funções metabólicas e neurotróficas. Sua deficiência está associada a distúrbios hematológicos, neurológicos e psiquiátricos. É relatado o caso de uma paciente com depressão refratária ao tratamento com antidepressivos que melhorou somente após a detecção e o tratamento da deficiência de vitamina B12. Esse relato ilustra a importância de o psiquiatra considerar causas secundárias de depressão em casos refratários

Clinical management of a patient with drug dependence who attempted suicide while receiving peginterferon therapy for chronic hepatitis C

Pegylated interferon-alpha combined with ribavirin is the current gold standard treatment for chronic hepatitis C. Illicit drug dependence is not a rare co-morbidity among chronic hepatitis C population, what can make antiviral treatment an outmost challenge. Despite high sustained virological response rate following antiviral treatment, serious psychiatric adverse reactions may occur, like depression and suicide attempt. We report a patient with recurrent depressive disorder, previous history of suicide attempt and illicit drug dependence. We discuss the singularities and challenges of managing this patient in order to complete the antiviral treatment

Perfil hematológico de morcegos frugívoros, Artibeus lituratus (Chiroptera: Phyllostomidae)

It was provide a hematological profile of Artibeus lituratus (Phyllostomidae: Stenodermatinae). Animals were collected from October 2017 to February 2018 in an urban forest in the city of Rio de Janeiro, Southeastern Brazil. Males and females showed similar overall mean values for the parameters analyzed. Males had higher values for erythrocytes (RBC), hematocrit and basophils. Females had higher levels of eosinophils than males. The hematological values reported here will serve as reference for future research on health conditions of free-living and captive populations of Artibeus lituratus, as well as for research on pathogens associated with these bats.O presente trabalho estabeleceu o perfil hematológico de morcegos frugívoros de vida livre, A. lituratus (Phyllostomidae: Stenodermatinae). As amostragens foram realizadas de outubro de 2017 a fevereiro de 2018 em uma floresta urbana na cidade do Rio de Janeiro, Sudeste do Brasil. Machos e fêmeas apresentaram valores médios gerais semelhantes para os parâmetros analisados. Os machos apresentaram valores de eritrócitos (RBC), hematócrito e basófilos mais altos. As fêmeas apresentaram níveis mais elevados de eosinófilos que os machos. Os valores hematológicos aqui reportados servirão de referência para pesquisas sobre condições de saúde de populações de Artibeus lituratus em vida livre e de cativeiro, assim como para pesquisas sobre patógenos associados a esses morcegos

Sexual dysfunction and dissatisfaction in chronic hepatitis C patients

IntroductionThe prevalence of sexual dysfunction (SD) and dissatisfaction with sexual life (DSL) in patients with chronic hepatitis C virus infection (CHC) was jointly investigated via a thorough psychopathological analysis, which included dimensions such as fatigue, impulsiveness, psychiatric comorbidity, health-related quality of life (HRQL) and sociodemographic and clinical characteristics.MethodsMale and female CHC patients from an outpatient referral center were assessed using the Brief Fatigue Inventory, the Barrat Impulsiveness Scale, the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale (HAM-A), and the World Health Organization Quality of Life Scale-Brief Version (WHOQOL-BREF). Structured psychiatric interviews were performed according to the Mini-International Neuropsychiatric Interview. SD was assessed based on specific items in the BDI (item 21) and the HAM-A (item 12). DSL was assessed based on a specific question in the WHOQOL-BREF (item 21). Multivariate analysis was performed according to an ordinal linear regression model in which SD and DSL were considered as outcome variables.ResultsSD was reported by 60 (57.1%) of the patients according to the results of the BDI and by 54 (51.4%) of the patients according to the results of the HAM-A. SD was associated with older age, female gender, viral genotype 2 or 3, interferon-α use, impulsiveness, depressive symptoms, antidepressant and benzodiazepine use, and lower HRQL. DSL was reported by 34 (32.4%) of the patients and was associated with depressive symptoms, anxiety symptoms, antidepressant use, and lower HRQL.ConclusionsThe prevalence of SD and DSL in CHC patients was high and was associated with factors, such as depressive symptoms and antidepressant use. Screening and managing these conditions represent significant steps toward improving medical assistance and the HRQL of CHC patients

Health related quality of life among patients with chronic hepatitis C: a cross-sectional study of sociodemographic, psychopathological and psychiatric determinants

INTRODUCTION: Chronic hepatitis C virus infection patients have higher rates of psychiatric disorders than the general population. Chronic hepatitis C virus infection is known to be associated with impaired health related quality of life. To our knowledge, there is no previous research of health related quality of life in chronic hepatitis C patients that combined structured psychiatric interview and careful psychopathological evaluation, including depression, anxiety and fatigue instruments. The aim of this study was to evaluate health related quality of life of chronic hepatitis C patients and to investigate the association with sociodemographic, psychopathological and psychiatric factors. MATERIALS AND METHODS: Eighty-one individuals with chronic hepatitis C virus infection receiving care at a Brazilian public university-based outpatient service for infectious diseases were enrolled in the study. The World Health Organization Quality of Life Scale Brief Version was used to assess health related quality of life. Standard psychiatric interview (Mini International Neuropsychiatric Interview-Plus) was conducted to establish Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I psychiatric diagnosis. Further instruments completed psychopathological investigation: Beck Depression Inventory, Hospital Anxiety and Depression Scale, Brief Fatigue Inventory, Hamilton Depression Scale and Hamilton Anxiety Scale. Pearson Chi-Square and Kruskal-Wallis were performed for categorical and continuous univariate analysis, respectively. Correlation between psychopathological and health related quality of life scores was performed according to Spearman's correlation. Multivariate analysis was performed according to stepwise forward ordinal logistic regression. The significance threshold was fixed at α = 0.05. RESULTS: Depressive disorders were associated with worse scores in overall health related quality of life and in all domains. Fatigue was associated with lower scores in physical and psychological domains, and married status with higher scores in psychological health related quality of life. We found strong correlation among scores of depression, fatigue and health related quality of life. CONCLUSION: Depression and fatigue must be properly investigated and managed in HCV patients in order to improve HRQL. WHOQOL-BREF proved to be a useful instrument to assess HRQL in HCV patients

Exploring pottery use in the Southwestern Atlantic Europe: an approach from the organic residue analysis

Session IV-3. Apport des approches technologiques de la céramique à l'anthropologie et à l'archéologie des sociétés pré et protohistoriquesInternational audienceThe origin and spread of pottery vessels marked an important change in culinary practices of prehistoric societies. Its introduction across Europe followed different geographic patterns and processes. In this context, the introduction and adoption of pottery technology in the western extreme of the continent occurred later than in other parts of South Europe.This presentation is focused on the earliest evidence of pottery use along the Southwestern Atlantic coast of Europe. In this way, representative pottery assemblages from Portugal, Spain and France are used to investigate the role of this technology in relation to the arrival of the first domesticates to the region. By applying organic residue analysis on extracted lipids (i. e. gas chromatography, gas chromatography-mass spectrometry and gas-chromatography-combustion-isotope ratio mass spectrometry), this presentation assesses the function of pottery during this unprecedented cultural transition, which supposed the end of the hunter-gatherers communities in the region. Our results reveal considerable geographic variability in early pottery use related to the processing of different animal products. The results have significant implications for discussing regional patterns in Neolithic diffusion and the nature of early agropastoral economies in western Europe