Objectives Hepatitis C is one of the main causes of chronic liver diseases worldwide. One of the major barriers to effecting EU- and WHO-mandated HCV elimination by 2030 is underdiagnosis. Community-based screening strategies have been identified as important components of HCV models of care. HepCheck Europe is a large-scale intensified screening initiative aimed at enhancing identification of HCV infection among vulnerable populations and linkage to care. Methods Research teams across four European countries were engaged in the study and rolled out screening to high-risk populations in community addiction, homeless and prison services. Screening was offered to 2822 individuals and included a self-administered questionnaire, HCV antibody and RNA testing, liver fibrosis assessment and referral to specialist services. Results There was a 74% (n=2079) uptake of screening. The majority (85.8%, n=1783) were male. In total 44.6% (n=927) of the sample reported ever injecting drugs, 38.4% (n=799) reported ever being homeless and 27.9% (n=581) were prisoners. In total 397 (19%) active HCV infections were identified and 136 (7% of total sample and 34% of identified active infections) were new cases. Of those identified with active HCV infection, 80% were linked to care, which included liver fibrosis assessment and referral to specialist services. Conclusions HepCheck’s screening and linkage to care is a clear strategy for reaching high-risk populations, including those at highest risk of transmission who are not accessing any type of care in the community. Elimination of HCV in the EU will only be achieved by such innovative, patient-centred approaches.
Background: Hepatitis C virus (HCV) is a main cause of chronic liver disease worldwide and is consistently under-diagnosed. Community-based screening initiatives, such as HepCheck, have been identified as important components of HCV care. HepCheck focuses on screening and identifying HCV RNA-positive cases in high-risk populations and linking them to care as part of a larger European project to improve HCV care (HepCare). Methods: HCV testing with a self-administered questionnaire was offered to 2822 individuals. Results: There were 2079 patients screened. Overall, 397 (19%) of the total screened cohort were identified as having active HCV infections as measured by HCV RNA PCR. The patients were mostly male (84%), white (88%), and had a history of injecting drug use (IDU) (86%), homelessness (58%), and tattooing (42%). There were 136 new cases (7% of the total sample and 34% of identified active infections). Romania had the highest proportion of newly identified cases with 87%, then Ireland with 60%, and Spain with 43%; the UK had the lowest proportion of new cases at 10%. Conclusions: For those lost to follow-up, a major strategy is re-engagement. For those newly diagnosed, the 'seek and treat' approach is a key strategy. Thus, different priorities are defined for different countries.
The South American native species Tuta absoluta is recognized as a tomato pest with fulminant dispersal ability in the new invaded areas. T. absoluta monitoring in all tomato-producing regions of the country is a vital step in early detection and integrated management decision-making. The aim of the study was to elucidate the interval of occurrence and population dynamics of T. absoluta in Muntenia region, respectively the vegetable basin that supply Bucharest northern markets. The paper presents the results of pest monitoring carried out in 2016, 2017, 2018 and 2019, by using pheromone-baited traps and also by visual inspection of tomato crops in various greenhouses in four localities from Bucharest surrounding area. The study provides first systematic monitored data about T. absoluta dynamics in protected tomato crops from southern Romania. Depending on year weather conditions, in the greenhouses tomato crops from the investigated area, the tomato leaf miner completed maximum 3 to 4 generations from spring to autumn and the degree of attack on tomatoes reached its maximum at the end of the second vegetation cycle. There was also noted a steady annual increase in the number of adult catches and degree of attack on tomatoes in the protected crop from analysed area.
This review aimed to analyze the latest neurobiological findings regarding Korsakoff syndrome, since alcoholism is the most prevalent addiction worldwide. In addition, we analyzed the optimal treatment that can be administered in order to minimize the symptoms and improve the outcome of these patients. The disruption of memory circuits within the brain of alcoholic patients results in the amnestic syndrome known as Korsakoff syndrome. It is generally characterized by a chronic neuropsychiatric syndrome caused by vitamin B1 (thiamine) deficiency. Other categories of patients can develop Korsakoff syndrome without consuming alcohol such as AIDS patients, terminally ill cancer patients, or patients with chronic infections and malnutrition. Vitamin B1 is required in the Krebs cycle for production of adenosine triphosphate (ATP). It is also a cofactor in the production of acetylcholine and certain neurotransmitters. Alcohol consumption can decrease the intake, gastrointestinal absorption and cellular utilization of vitamin B1. Treatment of alcohol withdrawal along with high doses of vitamin B1 can improve the general outcome of patients. A small percentage of patients can recover from Wernicke's encephalopathy with no permanent brain damage. The onset of Korsakoff syndrome darkens the prognosis. Alcohol abstinence is an absolute recommendation and prevents the extension of neural damage. Contents 1. Research methods 2. Introduction 3. Clinical features 4. Neurobiology 5. Treatment strategies 6. Conclusions Research methodsThe review started from an extensive search of Korsakoff syndrome for the last 10 years over the database PubMed ® /MEDLINE (http://www.ncbi.nlm.nih.gov/pubmed). Even if the trigger for this disease can be found in more than 2,700 scientific articles and 9 clinical trials, the Korsakoff keyword returned only 160 published scientific papers, 91 in the last 5 years and only one clinical trial. As research keywords we used 'Korsakoff' OR 'Korsakoff syndrome' OR 'Wernicke' AND 'Wernicke encephalopathy' AND 'alcohol' AND 'Thiamine' AND 'brain structures' AND 'treatment'. In the same time 'Korsakoff' search over Web of Knowledge returned 342 scientific articles but only one published in Romania. We constructed an Excel table highlighting these findings, we eliminated the duplicates, we kept the review articles because some of them bring upfront old results or ideas that are still valid and useful.
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