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Objective: Dolutegravir, an HIV integrase inhibitor, is a relatively new treatment option. To assess the tolerability, side effects, and time to viral decline to non-detectable in patients newly started on dolutegravir. Methods: Retrospective health care record of 61 consecutive HIV treatment-naive patients started on dolutegravir was reviewed and analysed on SPSS. Results: The mean initial viral load was 160826.05 copies/mL (range, 79–1,126,617 copies/mL). HIV viral load became non-detectable in 63.9% of patients on dolutegravir within 3 months. In all, 60.7% of patients reported no side effects on dolutegravir; 98.4% of the patients claimed full compliance to their antiretrovirals. Conclusion: Dolutegravir was found to be efficacious and well tolerated in HIV-infected treatment-naive patients.

Background and Aims: Chronic hepatitis C HCV infection is responsible for considerable health and economic burden in EU. In the last decade, Romania faced an alarming increase in the number of newly diagnosed HIV/HCV co-infected injecting drug users IDUs. It is increasingly being recognised that addressing this global challenge requires effective cooperation between primary and secondary care and multidisciplinary approaches to care. Besides there is urgent need to implement efficient programs to lower HCV spread among patients from vulnerable groups. As part of a project to integrate primary and secondary care for patients at risk of, or infected with HCV HEPCARE, we developed Multidisciplinary Educational Masterclass Series for healthcare professionals working in primary care, in partner countries UK, Ireland, Spain and Romania. Peer-support sessions and educational materials for patients were also developed in all partner countries. This paper aims to describe and evaluate the series and examine how this model might be implemented in practiceMethod: From local general practice, NGOs and Addiction Treatment Services, GPs/other healthcare professionals working in primary care were invited to eight one-day symposia HCV Masterclass series examining the burden of HCV, how to prevent new infections, why/how to screen, new approaches to diagnosis/treatment, management of HIV/HCV co-infection in IDUs, and treating coexisting problem alcohol use. Peer-support sessions as training day programmes and flyers were offered to homeless people and IDUs.Results: Over 200 participants involved in HCV care in the community from participating countries attended the Masterclass series. 100% of participants ‘strongly agreed’ or ‘agreed’ that the Masterclass helped them “appreciate the role of primary care” and “secondary care” in “the management of patients with HCV” as well as “describing new approaches to assessment Fibroscan” 97-100% and “treatment” 88-96% of patients with HCV especially in countries where the Interferon-free regimens were implemented more recently e.g. Romania. In regards to making an integrated model of care happen in practice, 100% of participants indicated the importance of a “designated nurse to liaise with hospital services” and that “educational programmes” 91-100% and “computerised-decision making” 88-92% would also be of value. Patients from vulnerable groups were addressed also in 11 peer-support sessions and by distributing printed educational materials for high risk behaviour patients/ HCV positive patients in waiting rooms at primary care facilities or emergency rooms of hospitals.Conclusion: This paper highlights the potential importance of integrated approaches to healthcare and also addressing the educational level of the patients in optimising hepatitis C care in the community, strategies that can enhance effective implementation.

Background: In Ireland and the EU, chronic hepatitis C (HCV) infection is responsible for a considerable health and economic burden. It is increasingly being recognised that addressing this global challenge requires effective cooperation between primary and secondary care and multidisciplinary approaches to care. As part of a project to integrate primary and secondary care for patients at risk of, or infected with HCV (‘Hepcare Europe’), we developed a Multidisciplinary Educational Masterclass Series for healthcare professionals working in primary care. This paper aims to describe and evaluate the series and examine how this model might be implemented in practice.Methods: From local general practice, NGOs and Addiction Treatment Services, GPs and other healthcare professionals working in primary care were invited to two one-day symposiums (Hepatitis C Masterclass) which examined how to prevent new infections, why / how to screen, new approaches to diagnosis and treatment, treating coexisting problem alcohol use.Results: 34 healthcare professionals attended the two masterclasses. 100% of participants ‘strongly agreed’ or ‘agreed’ that the Masterclass helped them “appreciate the role of primary care” and “secondary care” in “the management of patients with HCV” as well as “describing new approaches to assessment (Transient Elastography testing)” (96-100%) and “treatment” (85-96%) of patients with HCV. In regards to making an integrated model of care happen in practice, 100% of participants indicated the importance of a “desginated nurse to liaise with hospital services” and that “educational programmes” (91-100%) and “computerised-decision making” (88-92%) would be also be of value.Discussion: This paper highlights the potential importance of integrated approaches to healthcare in optimising hepatitis C care in the community and identifies strategies that can enhance effective implementation.

The cladding of the unbrazed samples is characterized by a uniform distribution of Si particles inside of the clad. After brazing the clad structure contains a mixture of a solid solution and binary eutectic (α + Si). TEM analysis illustrates that the core alloy contained the following types of particles: large, bearing, Al 6 (Fe,Mn) particles with an equal atomic ratio of Fe to Mn and a high density of uniformly distributed α-(Al-Mn-Si) dispersoid particles. SAD pattern and compositional analysis of the α-dispersoid particles revealed a cubic structure with an Im3 space group and a lattice parameter a = 12.68x10 -10 m. There is evidence of diffuse scattering in the (100) orientation, related to the establishment of short range ordering of manganese in α-(Al-Mn-Si). There is a significant amount of recrystallization occurring in the core alloy during the short time at the brazing temperature. Depending on the previous thermomechanical processing of the core alloy, after brazing all samples reveal mostly recrystallized microstructure, free of dislocations with medium and high angle boundaries. Al 6 (Fe,Mn) particles served as the dominant nucleation mechanism for the recrystallized microstructure.