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.

Chronic liver diseases such as non-alcoholic fatty liver disease NAFLD and alcoholic liver disease ALD are common and can lead to advanced liver fibrosis ALF, which requires specialist care to prevent serious complications like cirrhosis. This study compares two blood tests, eLIFT and FibroMeter, for screening ALF in patients with NAFLD andor ALD seen in primary care. These tests aim to help general practitioners identify patients who need specialist referral, as current methods are often normal despite underlying disease. The study evaluates the diagnostic accuracy of the eLIFT and FibroMeter blood tests, using elastography and liver biopsy as references when needed. Participants provide blood samples which are tested with both methods. The study is conducted in a primary care setting with one diagnostic arm, assessing how well these tests screen for ALF. The study also explores patient adherence to screening and compares referral rates and costs associated with each test. Participants will undergo blood sampling and may have elastography or liver biopsy if indicated. Researchers will collect data on test sensitivity, referral rates to specialists, and detection of liver complications such as cancer or varices. The study tracks outcomes over days to a month after screening to evaluate test performance and patient management. Participation includes giving informed consent and allowing sample collection, with monitoring of adherence and clinical outcomes during the study period.