Combourg

Researchers are investigating the use of a hypnotherapy method called E2R to manage chronic insomnia in primary care settings. Chronic insomnia is commonly treated with hypnotic drugs in France despite their risks, while cognitive-behavioral therapy is recommended but not widely available. This study aims to compare the effectiveness of E2R hypnotherapy against standard care without hypnosis in patients with chronic insomnia. Participants will be randomly assigned to one of two groups. One group will receive standard care from their general practitioner, which may include medications or psychotherapy but excludes hypnosis. The other group will undergo four 30-minute hypnotherapy sessions using the E2R method over six weeks, with additional practice of self-hypnosis. Both groups will have follow-up visits at 3 and 6 months after starting the study. During the study, patients will complete questionnaires assessing insomnia severity and sleep quality, record their use of psychotropic medications, and note any events affecting sleep. The research team will also monitor for neuropsychiatric side effects. These assessments occur at baseline, 3 months, and 6 months, with the main outcome measured by the Insomnia Severity Index at 6 months. Participation will last at least 6 months from enrollment.

Researchers are comparing two blood tests, eLIFT and FibroMeter, to screen for advanced liver fibrosis in patients with Non-alcoholic Fatty Liver Disease NAFLD and Alcoholic Liver Disease ALD in primary care settings. These liver conditions affect a large portion of the adult population and can lead to serious complications if fibrosis progresses. The study aims to evaluate how well these tests help general practitioners identify patients who need specialist referral, as current physical exams and usual tests often miss advanced fibrosis. The study involves a diagnostic evaluation using blood tests eLIFT and FibroMeter alongside elastography devices and liver biopsy when needed. Only one arm is included since this is a diagnostic study. The tests are assessed for sensitivity and specificity in detecting advanced liver fibrosis. The study is conducted in primary care centers with patients aged 40 to 80 years who have NAFLD andor ALD and meet specific risk criteria. Participants will undergo blood testing and elastography, and liver biopsy may be performed if indicated by elastometry results. Researchers will measure the sensitivity of each test for detecting advanced fibrosis and track patient referrals to specialists. Additional outcomes include rates of unnecessary referrals, detection of liver cancer or varices, patient adherence to screening, and cost analysis. The study includes follow-up assessments within one month after screening to gather comprehensive data on screening effectiveness and patient outcomes.