Disease In Europe Research Articles

Aortic Valve Stenosis: Diagnostic Approaches and Recommendations of the 2021 ESC/EACTS Guidelines for the Management of Valvular Heart Disease -A Review of the Literature.

Aortic stenosis (AS) is the most common valvular heart disease in Europe and North America requiring a surgical or interventional treatment. Due to demographic changes with an aging population the burden of valvular heart diseases and especially the importance of aortic stenosis (AS) will be growing in future. As the onset of symptoms is associated with a decrease in life expectancy appropriate and early diagnosis are of utmost importance. However, insights of clinical practice underline diagnostic challenges which may lead to a delayed initiation of treatment with an adverse effect on the prognosis. The aim of this review is to display different diagnostic approaches that may be helpful in detecting patients with aortic valve stenosis. This review will focus on both non-invasive and invasive diagnostic approaches that can be implemented in clinical routine. Further-more, we will especially highlight recommendations of the 2021 European guidelines for the management of valvular heart disease.Methods:For this review a selective literature research on the databases PubMed and Google Scholar was conducted. Original articles, reviews and meta-analyses were included when meeting our search criteria. Following terms were used in different combinations: Aortic valve stenosis; Aortic stenosis; diagnosis of aortic stenosis; ESC Guidelines for the management of valvular heart disease.

MODIRISK: Mosquito vectors of disease, collection, monitoring and longitudinal data from Belgium.

The MODIRISK project studied mosquito biodiversity and monitored and predicted biodiversity changes, to actively prepare to address issues of biodiversity change, especially invasive species and new pathogen risks. This work is essential given continuing global changes that may create suitable conditions for invasive species spread and the (re-)emergence of vector-borne diseases in Europe. Key strengths of MODIRISK, in the context of sustainable development, were the links between biodiversity and health and the environment, and its contribution to the development of tools for describing the spatial distribution of mosquito biodiversity. MODIRISK addressed key topics of the global Diversitas initiative, which was a main driver of the Belspo 'Science for a Sustainable Development' research program. Three different MODIRISK datasets were published in the Global Biodiversity Information Facility (GBIF): the Collection dataset (the Culicidae collection of the Museum of Natural History in Brussels); the Inventory dataset (data from the MODIRISK inventory effort); and the Longitudinal dataset (experiment data used for risk assessments).

Climate Changes Exacerbate the Spread of Ixodes ricinus and the Occurrence of Lyme Borreliosis and Tick-Borne Encephalitis in Europe-How Climate Models Are Used as a Risk Assessment Approach for Tick-Borne Diseases.

Climate change has influenced the transmission of a wide range of vector-borne diseases in Europe, which is a pressing public health challenge for the coming decades. Numerous theories have been developed in order to explain how tick-borne diseases are associated with climate change. These theories include higher proliferation rates, extended transmission season, changes in ecological balances, and climate-related migration of vectors, reservoir hosts, or human populations. Changes of the epidemiological pattern have potentially catastrophic consequences, resulting in increasing prevalence of tick-borne diseases. Thus, investigation of the relationship between climate change and tick-borne diseases is critical. In this regard, climate models that predict the ticks’ geographical distribution changes can be used as a predicting tool. The aim of this review is to provide the current evidence regarding the contribution of the climatic changes to Lyme borreliosis (LB) disease and tick-borne encephalitis (TBE) and to present how computational models will advance our understanding of the relationship between climate change and tick-borne diseases in Europe.

Management of Vernal Keratoconjunctivitis in Children in the United Kingdom: A Review of the Literature and Current Best Practice Across Six Large United Kingdom Centers.

Vernal keratoconjunctivitis (VKC) is a form of ocular allergy primarily affecting children. Considered a rare disease in Europe, its prevalence varies by geographic region and is poorly studied in the United Kingdom. There is considerable national variation in the management of VKC within the United Kingdom, risking misdiagnosis and delays to treatment for some children. This can significantly impact their quality of life, with the potential for lasting negative consequences. Based on discussions between experienced clinicians from six large centers across the United Kingdom, this article describes best practice recommendations for United Kingdom settings, including principles for diagnosis, referral, initial and long-term management, and supportive care. Recommendations include guidance on referral timing, which should depend on VKC severity, and a stepwise approach to treatment. Joint management by primary care and secondary care is recommended and the importance of supportive care, including emotional support and outreach to schools, is highlighted. Because frequent flareups are common in VKC, it is essential that families have access to the information they need to manage the disease and routes to access rapid care if needed. A thorough understanding of the nature of VKC, its triggers, and how best to manage it, by both patients and their families, is critical to ensuring appropriate management and to improving patient outcomes. [J Pediatr Ophthalmol Strabismus. 2023;60(1):6-17.].

The epidemiology of infectious diseases in Europe in 2020 versus 2017–2019 and the rise of tick-borne encephalitis (1995–2020)

Health control measures instituted in 2020 to mitigate the COVID-19 pandemic decreased the case numbers of many infectious diseases across Europe. One notable exception was tick-borne encephalitis (TBE). In Austria, Germany, Switzerland, Lithuania, and the Czech Republic, the upturn was significantly higher compared to the average of the three years previously (P<0.05), with increases of 88%, 48%, 51%, 28%, and 18%, respectively. Six countries reported TBE incidences of ≥5 cases/100,000, defined as highly endemic by the World Health Organization (WHO). Possible factors contributing to this surge may include increased participation in outdoor activities in endemic regions and increased tick counts/tick activity. In highly endemic regions, the WHO recommends that vaccination be offered to all age groups, including children.

Experience of discrimination during COVID-19 pandemic: the impact of public health measures and psychological distress among refugees and other migrants in Europe

BackgroundThe COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020).MethodsParticipants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2.ResultsIn the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection.ConclusionsRefugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.

TAVI, multidimensional early benefits in elderly patients

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Aortic stenosis is the most common valvular heart disease in Europe and in symptomatic patients, when untreated presents a high rate of morbidity and mortality. Its prevalence is estimated to grow even more, given the aging of the population. Transcatheter aortic valve implantation (TAVI) emerged as a safe and efficient procedure in patients with high or prohibitive surgical risk or in older patients, who are much often frailty, with impaired cognitive function and have poor quality of life. Aim To assess the acute benefits (in 1 moth) of TAVI on cognitive function, anxiety and depression and independence in activities of daily living. Methods Single center prospective study of patients submitted to TAVi between April 2021 and September 2021. Patients were evaluated at baseline (before TAVI) and one month after the procedure. To assess cognitive function, anxiety and depression and independence in activities of daily living we used the Mini Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS); Katz Index of Independence in Activities of Daily Living; and Lawton-Brody Instrumental Activities of Daily Living Scale, respectively. Paired sample t-test and Wilcoxon test were used to statistical analysis. Results We included 20 patients, with a mean age of 85±5,86 years, 40% (8) male. 19 patients undergone TAVI due severe native aortic stenosis and 1 due to bioprosthetic aortic valve dysfunction. The vascular access site was transfemoral in 19 patients and transapical in 1 patient. The median MMSE results were higher 1 month after TAVI (21,3 versus 23,5, p=0,012), essentially due to a better results in the temporal orientation and evocation domains (p=0,011 and p=0,022, respectively). Patients experienced lower levels of anxiety and depression after TAVI, mean score 5,4 versus 3,9 (p=NS) and 7 versus 4,25 (p=0,002) respectively for anxiety and depression, as assessed by HADS scale. No statistical difference was observed on the results of basal and post TAVI evaluation of Katz and Lawton-Brody scales. Conclusion In an elderly population, TAVI appears to have an early and beneficial effect on cognitive function and depression, but no benefits were observed on independence in activities of daily living.

Forest Diversity Reduces the Prevalence of Pathogens Transmitted by the Tick Ixodes ricinus

Tick-borne diseases represent the majority of vector-borne human diseases in Europe, with Ixodes ricinus, mostly present in forests, as the main vector. Studies show that vertebrate hosts diversification would decrease the prevalence of these pathogens. However, it is not well known whether habitat diversity can have similar impact on ticks and their infection rates. We measured the presence and abundance of different stages of I. ricinus, and the prevalence of associated pathogens in a large-scale forest experiment in which we manipulated tree diversity and moisture level. We showed that larval abundance was influenced by tree species identity, with larvae being more present in pine plots than in oak plots, while nymph abundance increased with canopy tree density. The proportion of Borrelia burgdorferi s.l.-infected nymphs decreased with increasing tree diversity. Our findings suggest that tree overstorey composition, structure and diversity, can affect tick abundance and pathogen prevalence. They support the idea that forest habitats may have “diluting” or “amplifying” effects on tick-borne diseases with direct relevance for human health.

Setting the scene for (rare) endocrine diseases in Europe

Setting the scene for (rare) endocrine diseases in Europe

Temperate climate malaria in nineteenth century Denmark

BackgroundPlasmodium vivax was endemic in northern Europe until the early twentieth century. Considering climate change and the recent emergence of other vector borne diseases in Europe, historical insight into the relationship between malaria and environmental factors in northern Europe is needed. This article describes malaria epidemiology in late-nineteenth century Denmark.MethodsWe described the seasonality and spatial patterns of malaria, and the relationship of the disease with environmental factors such as soil types, clay content and elevation for the period 1862–1914. We studied demographic and seasonal patterns and malaria mortality in the high-morbidity period of 1862–1880. Finally, we studied the relationship between malaria seasonality and temperature and precipitation using a Spearman correlation test.ResultsWe found that the highest incidence occurred in eastern Denmark. Lolland-Falster medical region experienced the highest incidence (14.5 cases per 1000 pop.) and Bornholm medical region experienced the lowest incidence (0.57 cases per 1000 pop.). Areas with high malaria incidence also had high soil clay content, high agricultural production, and Lolland-Falster furthermore has a low elevation. Malaria incidence typically peaked in May and was associated with high temperatures in July and August of the previous year but not with precipitation. The case fatality rate was 0.17%, and the disease affected both sexes and all age groups except for infants. In 1873, a large epidemic occurred following flooding from a storm surge in November 1872.ConclusionsMalaria gradually declined in Denmark during our study period and had essentially disappeared by 1900. The high adult and low child morbidity in 1862–1880 indicates that malaria was not highly endemic in this period, as malaria is most frequent among children in highly endemic areas today. The association of high malaria incidence in spring with warmer temperatures in the previous summer suggests that transmission took place in the previous summers. The close geographical connection between malaria and soil types, agricultural production and elevation suggests that these factors are detrimental to sustain endemic malaria. Our findings of a close connection between malaria and environmental factors such as climate and geography provides insights to address potential reintroduction of malaria in temperate climates.

A review analysis of global Bluetongue virus-related research articles from 2000 to 2020

Bluetongue virus (BTV) is an arbovirus, causes bluetongue (BT) disease of ruminants responsible for mortality and trade limitation. The objective of this study was to provide a descriptive review analysis of global research activity for the period 2000 to 2020. The number of articles, temporal evolution, geographical distribution, countries, funding agencies, authors, research theme, and the source was analyzed and presented in visualization maps. Search query resulted in 3878 documents from 5681 authors, and 2017 articles were analyzed. The annual number of publications showed a steep increase from 2005 to 2020 related to attention to BT as an exotic disease in Europe, as well as the interest in vector over-distribution due to climate change. Most of the studies were performed in Europe, followed by Asia and North America. The top active countries in article production were the United Kingdom and the United States. A considerable international collaboration network of the UK with the USA and European countries was observed. However, the collaboration was weak with Asian and African countries. The major research themes are genomic viral studies, the role of Culicoides as a vector, serological and molecular epidemiology, and vaccination. In conclusion, an increase in scientific production and international collaboration was noticed during the last two decades. However, international collaboration needs more attention to African, and South American countries. The current study provides useful references for the policymaker, academics, animal health professionals, and funding agencies to follow the past and except the future BTV themes.

Epidemiological features of the incidence of acute myocardial infarction among the population of Kharkiv region

Ukraine has one of the highest death rates from circulatory diseases in Europe compared to the countries of the European region. The aim of this study is to determine and analyze the incidence of acute myocardial infarction as one of the leading diseases of the circulatory system. Аnalysis of the incidence of acute myocardial infarction among the adult population of the Kharkiv region in the dynamics of 2014–2018, was carried out according to the Kharkiv Regional Information and Analytical Center for Medical Statistics. Determined that the incidence of acute myocardial infarction in 2018 was higher in Kharkiv than in Kharkiv region: among the population of Kharkiv region it was 100.77 per 100,000 population, in Kharkiv – 120.940/0000, and in the region this figure was equal to 77.650/0000. Analysis of the incidence of acute myocardial infarction by sex for the period 2014–2018 among the adult population of Kharkiv region showed that this figure among men is much higher than among women – 128.320/0000 against 76.990/0000 among women. The highest incidence rate among men in Kharkiv region was recorded in 2015 (157.99 per 100,000 male population), the lowest – in 2018 (128.32 per 100,000 male population). The incidence rate among the female population of Kharkiv region for the period 2014–2018 ranged from 76.99 to 87.71 per 100,000 female population. According to the results of the study, it was found that the incidence of acute myocardial infarction is an urgent problem that has epidemiological features. It is determined that in the city of Kharkiv the incidence of acute myocardial infarction is higher than among the adult population of Kharkiv region (respectively 120.940/0000 vs. 77.650/0000). In the analysis of the incidence of acute myocardial infarction depending on gender for the period 2014–2018 among the adult population of Kharkiv region, it was found that this figure is much higher in men than in women. The incidence in 2018 among the male population of Kharkiv region was 128.32 and 76.99 among women per 100,000 population. Significant fluctuations in the incidence of myocardial infarction among the adult population of Kharkiv region for the period 2014–2018 indicate the need to improve preventive measures and improve the provision of medical care to patients with this pathology. Keywords: incidence; myocardial infarction; medical care.

Anti-TBE Intrathecal Synthesis as a Prediction Marker in TBE Patients.

Tick-borne encephalitis (TBE) is an emerging vector-borne disease in Europe caused by tick-borne encephalitis virus (TBEV), which belongs to Flaviviridae. Although most of the patients quickly recover from TBE, some require further neurological and psychiatric treatment due to persistent symptoms. The aim of the study was to evaluate the usefulness of an antibodies index for predicting the course of the disease and potential persistent sequalae. Sixty-six patients (49 males and 17 females, mean age 45.97 ± 13.69 years) with TBE hospitalized in the Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Poland, in years 2016–2019 were included to the study. TBE antibodies titer in serum and CSF samples were measured with an Anti-TBEV ELISA (IgM, IgG) EUROIMMUN test. Patients who developed persistent sequelae after TBE had significantly lower IgG intrathecal index at admission. Additionally, IgG2/IgG1was significantly higher in patients who developed sequelae. IgG intrathecal index might be a useful tool for the prediction of TBE sequelae development.

Prevalence of most common skin diseases in Europe: a population-based study.

BackgroundThe assessment of the prevalence of diseases is of primary importance in planning health policies. No complete data on the prevalence of skin diseases across European countries are available.ObjectiveTo estimate the prevalence of the most frequent skin conditions or diseases in 27 European countries (24 EU countries, plus Norway, Switzerland, and the United Kingdom).MethodsWe conducted a population‐based study on representative and extrapolable samples of the general population aged 18 years or more in each of the 27 countries surveyed. Participants were selected using stratified, proportional sampling with a replacement design. Data were collected using a web‐based online survey. All participants were asked to fill in a questionnaire with sociodemographic data and to declare if they have had one or more skin conditions or diseases during the previous 12 months.ResultsA total of 44 689 participants from 27 countries responded to the questionnaire, 21 887 (48.98%) men and 22 802 (51.02%) women. The proportion of participants who reported having suffered from at least one dermatological condition or disease during the previous 12 months was 43.35% (95% CI: 42.89%, 43.81%). The projection in the total population of the 27 countries included in the study resulted in 185 103 774 individuals affected by at least one dermatological condition or disease. Accordingly, we can estimate that more than 94 million Europeans complain of uncomfortable skin sensations like itch, burning, or dryness. The most frequent conditions were fungal skin infections (8.9%), acne (5.4%), and atopic dermatitis or eczema (5.5%). Alopecia, acne, eczema, and rosacea were more common in women, whereas men were more likely to suffer from psoriasis and sexually transmitted infections.ConclusionSkin diseases are an important public health concern. Their high prevalence has to be taken into account in planning access to dermatological care to address patient needs.

Urgent Support and Aid Needed for Ukrainian Patients with Rare Diseases and their Families

At the best of times, the 30 million people living with rare diseases in Europe require specific actions and support to achieve equitable access to health and social needs. In times of crisis, relief efforts must include specific consideration for the needs of this vulnerable population. The urgent need regarding people with a rare disease in Ukraine is for help to get vulnerable families safely out of the country and help to get essential medicines and supplies in.

Tick ecology and Lyme borreliosis prevention: a regional survey of pharmacists’ knowledge in Auvergne-Rhône-Alpes, France

The most prevalent vector-borne diseases in Europe are caused by tick-borne pathogens, such as bacteria of the genus Borrelia that cause Lyme borreliosis.In this context, retail pharmacists are frequently the first medical source of information in the event of a tick bite. The objective of this study was to assess pharmacy professionals’ knowledge about both tick ecology and the appropriate measures for tick bites and Lyme borreliosis prevention. It was based on an online survey of 364 pharmacists and pharmacy assistants located in the Auvergne-Rhône-Alpes region of France. The results showed solid knowledge about preventive measures for tick bite and Lyme borreliosis, but weaker knowledge about tick biology (hosts, suitable habitats, favorable conditions for tick activity, etc.). In particular, several stereotypes were observed in the responses of the pharmacy professionals. These appear to result from a social construction of the knowledge on ticks and tick-borne diseases previously shown to the general population in the region. The results highlight the need for continuous training about ticks and tick-borne diseases for healthcare professionals serving local populations that live in endemic areas.

Orthohepevirus C infection as an emerging cause of acute hepatitis in Spain: First report in Europe

Hepatitis E virus (HEV) was considered the only member of the Hepeviridae family with zoonotic potential. Nevertheless, this consideration has been reassessed owing to several reported cases of acute and chronic hepatitis linked to the Orthohepevirus C genus. Because the circulation of Orthohepevirus C in rodents has been described worldwide, the risk of zoonotic transmission is plausibly global. Orthohepevirus C RNA was retrospectively evaluated in 2 cohorts of patients in Spain. The first cohort included patients with acute hepatitis without etiological diagnosis after screening for hepatotropic virus infection. The second cohort included patients diagnosed with acute HEV infection, defined as positivity for anti-HEV-IgM antibodies and/or detectable HEV RNA in serum. Cohort 1 comprised 169 patients (64.4% male, median age 43 years) and cohort 2 comprised 98 individuals (68.3% male, median age 45 years). Of the individuals included in Cohort 1, two (1.18%; 95% CI 0.2-3.8) had detectable Orthohepevirus C RNA in serum. In Cohort 2, of the 98 included patients, 58 showed detectable HEV RNA, while 40 only showed positivity for IgM antibodies. Among those bearing only IgM antibodies, Orthohepevirus C RNA was detected in 1 (2.5%; 95% CI 0.06-13.1) individual. All strains were consistent with genotype C1. The infection resulted in mild self-limiting acute hepatitis in 2 patients. Infection caused severe acute hepatitis in the remaining patient who died as a result of liver and renal failure. We described 3 cases of Orthohepevirus C in patients with acute hepatitis, resulting in the first description of this infection in Europe. The prevalence obtained in our study suggests that Orthohepevirus C could be an emerging disease in Europe. We describe the first cases of acute hepatitis related to rat hepatitis E virus in Europe. The prevalence found in our study suggest that rat hepatitis E virus could be considered an emerging disease in Europe.

The Atlas of cardiovascular disease in Europe and a focus on frailty and cardiovascular risk.

The Atlas of cardiovascular disease in Europe and a focus on frailty and cardiovascular risk.

The Returns to Preventing Chronic Disease in Europe and the United States

The Returns to Preventing Chronic Disease in Europe and the United States

Incidence of Tick-Borne Encephalitis during the COVID-19 Pandemic in Selected European Countries.

Ixodes ricinus ticks are one of the most important vectors and reservoirs of infectious diseases in Europe, and tick-borne encephalitis (TBE) is one of the most dangerous human diseases transmitted by these vectors. The aim of the present study was to investigate the TBE incidence in some European countries during the COVID-19 pandemic. To this end, we analyzed the data published by the European Center for Disease Prevention and Control (ECDC) and Eurostat on the number of reported TBE and COVID-19 cases in 2020 and TBE cases in 2015–2019 (reference period). Significant differences in the TBE incidence were found between the analyzed countries. The highest TBE incidence was found in Lithuania (25.45/100,000 inhabitants). A high TBE incidence was also observed in Central European countries. In 12 of the 23 analyzed countries, there was significant increase in TBE incidence during the COVID-19 pandemic during 2020 compared to 2015–2019. There was no correlation between the incidence of COVID-19 and TBE and between the availability of medical personnel and TBE incidence in the studied countries. In conclusion, Central Europe and the Baltic countries are areas with a high risk of TBE infection. Despite the COVID-19 pandemic and imposed restrictions, the incidence of TBE is increasing in more than half of the analyzed countries.