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Background: In response to the goal of the World Health Organisation to eliminate hepatitis C virus infections by 2030, Romania is striving for national elimination. An already successful micro-elimination project was expanded to test-and-treat specific populations and at-risk groups. The aim of this project was to identify the individuals with HCV infection in disadvantaged regions who do not have proper medical care access. Materials and Methods: Our two-arm interventional cross-sectional study used rapid anti-HCV antibody testing on two population groups from the Romanian southwestern region of Oltenia, approached between September 2020 and May 2021. The first group consisted of predominantly over 40 years old individuals, recruited through five family doctors from two medium-sized towns (community lot—CL). We approached a second group, aged 18–65, through 11 medical offices of five large factories in the same region (industry lot, IL). A 12-items questionnaire was given to each participant, to determine risk factors and record demographic data. Eligible patients initiated antiviral therapy using direct-acting antivirals (DAAs). Results: We enrolled 15,383 individuals between all 16 locations. The overall prevalence by antibody testing was 0.77% (119 cases). Of these, 57 subsequently received treatment with DAAs. We identified blood transfusions as a risk factor within the CL. Participants in the IL reported a relatively high risk for the following situations: sharing of personal hygiene belongings with another person, performing previous blood transfusions, dental interventions and previous surgery. Conclusions: In this global context, the use of micro-elimination allows interventions to be faster and more efficient. This is possible by targeting smaller and specific HCV risk groups.

The aim of this study was to evaluate the correlation between motor and non-motor symptoms in patients diagnosed with Parkinson. We included in our study 72 patients diagnosed with Parkinson disease:28 female and 44 males. Each patient was evaluated using Non-motor Symptoms Questionnaire for Parkinson Disease, for motor status we used Unified Parkinson Disease Rating Scale (UPDRS) part 3 (motor part). The results of our study indicated that there is a correlation between the non-motor state and the motor symptoms but not in all non-motor domains. The study indicates that the digestive symptoms, the, cardiovascular, sleep and miscellaneous correlate with the motor symptoms but urinary symptoms, memory, hallucination, depression and sexual dysfunction does not show an interdependence with the motor state.

Rheumatoid arthritis is a systemic inflamatory disease that affects primarily the synovial joints and it is associated with a progressive disability and a important socio-economic burden. [1] Although the main characteristic is the joint involvement, it is important to remember that RA is a disorder with systemic involvement mainly due to it�s chronic inflamation. Patients with RA have a higher risk of cardio-vascular mortality that in general population. There are numerous studies that sugest that inflamation plays a key�role in the develompent of aterosclerosis and heart disease, therefore a better understanding of the inflamatory response in RA may lead to better outcomes for patients with RA. Metabolic Syndrome is described as a congregate of major risk factors for cardiovascular diseases (CVD): Diabetes and raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood presure[2]. The clustering of CVD risk factors that typifies the metabolic syndrome is now considered to be the driving force for a new CVD epidemic [3]. The conducted study aims to assess and evaluate the presence of metabolic syndrome (MetS) in RA patients. 120 patients with RA (89 women and 31 men) and 120 (85 women and 35 men) patients without RA were included in the study. The prevalence of MetS in RA patients was 39.16% and 22.5% for the control group. RA patients with MetS had significantly higher disease activity score of 28 joints index (DAS28-ESR) than patients without MetS ( 3.70 � 0.644 vs. 3.35 �0.725; p=0.006).

This review discusses and tries to demonstrate the importance of proinflammatory and antiinflammatory cytokines in HBV infection. Hepatitis B virus is a virus that is both hepatotropic and non-cytopathic. It causes the development of liver diseases which could progress into both acute and chronic versions. The virus is very widespread and results in the death of quite a number of people each year. The outcome of the viral infection is a result of immunologically mediated event. This means that the outcome is determined by the response of the immune system of the host. The infection can lead to several different liver diseases as well as fibrosis and cirrhosis. When an infection occurs, there is an attempt by the body to fight it via the use of several mechanisms. One of these is the use of cytokines (which are proteins). There exist different kinds of cytokines of which interleukin-10 and interferon gamma are very important. Interleukin-10 is an anti-inflammatory cytokine which inhibits the effector mechanism of Th1 cytokines. It performs hepatoprotective and anti-inflammatory functions and also upregulates Th2 cytokines. The function and relevance of this cytokine in the pathogenesis of liver diseases cannot be underemphasized. Interferon gamma, on the other hand, is a pro-inflammatory cytokine which seeks to eliminate and expunge the virus from the liver upon infection. It does this by congregating at the site of infection which subsequently results in inflammation and eventually liver fibrosis. This effect could be reversed by administering another type of interferon; interferon alpha.

The aim of this study was to identify correlations between electrocardiographic and echocardiographic changes in patients with silicosis prior to the occurrence of chronic pulmonary heart disease. We conducted a prospective, descriptive, analytical study, in which we included a group of 67 patients consecutively admitted to the Health Promotion and Occupational Medicine Clinic between December 2016 and January 2018, aged 47 to 78 years.There was a biochemical and electrocardiographic evaluation for each patient as well as a right ventricle echocardiographic evaluation (diameters, volumes, function). A control group, including 25 patients with benign minor diseases that required a cardiologist consultation, was also used. From the electrocardiographic point of view, slight changes were observed regarding the waves of electrical activity of the right ventricle. Taking into account the degree of ventilatory dysfunction (depending on FEV1), changes in right heart echocardiographic parameters were identified. Thus, in what the most important right ventricular parameters, including the tricuspid annular plane systolic excursion (TAPSE) or the RV index of myocardial performance (RVMPI) were concerned, values at the upper limit of normality were recorded in most patients with moderate and severe ventilatory dysfunction. Values of echocardiographic parameters of the right heart at the upper limit of normality, correlated with the degree of ventilatory dysfunction, are early markers for cardiovascular damage in patients with pulmonary silicosis prior to the occurrence of chronic pulmonary heart disease also known ascor pulmonale.

The aim of our study was to assess the percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of the left main coronary artery disease. The study was a prospective, analytical, observational descriptive one, it included a total number of 83 patients, consecutively included in order to avoid bias, for a period of three years between October 2012 and December 2015. The follow-up was performed for 3 years, initially at one month, then at an interval of three to six months. The primary clinical endpoint was mortality of any cause of the patients included in the study. Other main objectives assessed in our study were symptomatic ischemic heart disease manifested with angina pectoris, the need for myocardial revascularization, nonfatal myocardial infarction, and reduction of left ventricular ejection fraction. In patients with LMCAD, we noticed an increase in mortality in patients with PCI vs. CABG, recurrence of angina pectoris, acute myocardial infarction, myocardial revascularization, and depression of the ejection fraction of the left ventricle. In conclusion, the treatment of left main coronary artery disease by using coronary artery bypass grafting is superior to treatment using percutaneous coronary angioplasty.

Small bowel polyps present in images acquired by wireless capsule endoscopy are more difficult to detect using computer-aided diagnostic (CAD) systems. We aimed to identify the optimum morphological characteristics that best describe a polyp and convert them into feature vectors used for automatic detection of polyps present in images acquired by wireless capsule endoscopy (WCE). We prospectively included 54 patients with clinical indications for WCE. Initially, physicians analyzed all images acquired, identifying the frames that contained small bowel polyps. Subsequently, all images were analyzed using an automated computer-aided diagnostic system designed and implemented to convert physical characteristics into vectors of numeric values. The data set was completed with texture and color information, and then analyzed by a feed forward back propagation artificial neural network (ANN) trained to identify the presence of polyps in WCE frames. Overall, the neural network had 93.75% sensitivity, 91.38% specificity, 85.71% positive predictive value (PPV) and 96.36% negative predictive value (NPV). In comparison, physicians' diagnosis indicated 94.79% sensitivity, 93.68% specificity, 89.22% PPV and 97.02% NPV, thus showing that ANN diagnosis was similar to that of human interpretation. Computer-aided diagnostic of small bowel polyps, based on morphological features detection methods, emulation and neural networks classification, seems efficient, fast and reliable for physicians.