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Background: It is unclear whether treatment and care for hepatitis C virus (HCV) infection can help people who inject drugs (PWID) modify their injection drug use behaviours. This study examined changes in injection drug use among PWID with acute HCV systematically referred for HCV clinical assessment and treatment and offered targeted health care services, over the course of one year. Methods: The study sample included PWID with documented acute HCV infection recruited and followed-up semi-annually at least twice in IMPACT (2007-2015), a longitudinal community-based prospective study in Montréal, Canada. Following enrolment, participants with contra-indications to treatment due to severe co-morbidity were offered targeted health care services. Pegylated interferon-alpha (12-24 weeks) was offered to all other participants who did not spontaneously resolve their infection. At each study visit, data were collected on socio-demographic factors and drug use patterns. Logistic regression was used to assess changes in injection drug use at one-year follow-up. Results: Of the 87 eligible participants (mean age: 35.6; 78.2% male), 21.8% received treatment [(RT), Sustained virological response: 84.2%], 25.3% spontaneously resolved their infection (SR), 14.9% had contra-indication(s) (CI) and 37.9% chose not to engage in HCV care post-diagnosis (NE). In multivariate analyses adjusting for age, gender and injection drug use at baseline, the RT [Adjusted odds ratio (AOR): 0.18; 95% Confidence interval (CI): 0.04-0.76], SR (AOR: 0.34; 95% CI: 0.08-1.40), and CI (AOR: 0.24; 95% CI: 0.05-1.22) groups were less likely to report injection drug use at follow-up relative to the NE group. Conclusion: PWID who received treatment, spontaneously resolved their infection or presented with treatment contra-indication(s) reported reduced injection drug use at one-year follow-up relative to those who did not engage in therapy. Findings suggest that the benefits of HCV assessment and treatment may extent to helping PWID modify their injection drug use patterns. Refereed/Peer-reviewed

Background: People who inject drugs (PWID) have an elevated risk of suicide attempt. Although different substances are associated with suicide attempt, the overall risk posed by binge behavior, a high-risk pattern of drug use, remains unclear. The objective of this study is to assess the association between binge drug use and suicide attempt in a prospective cohort of PWID in Montreal, Canada. Methods: Participants answered a biannual interviewer-administered questionnaire compiling information on sociodemographics, pattern of substance use (cocaine, amphetamine, opioids, sedative-hypnotics, alcohol, and cannabis), and psychosocial stressors and related markers. The relationship between suicide attempt and binge behavior was modeled using generalized estimating equations (GEEs), controlling for type and pattern of substance use, sociodemographic characteristics, and significant mental health markers. Results: Among 1240 participants (mean age ± SD: 38.2 ± 9.8) at baseline, 222 (17.9%) reported binge during the past 6–months. PWID reporting binge were significantly younger ( P < .001), less educated ( P = .012), less likely male ( P = .047), and had shorter history of injection ( P < .001). In addition, they were younger at first injection ( P = .014), reported higher rates of prostitution and psychological disorders ( P = .003), and were more likely to use other drugs except cannabis and alcohol. Binge was independently associated with attempted suicide in the GEE multivariate model (adjusted odds ratio [aOR 95% CI] = 1.91 [1.38–2.65], P < .001). Conclusions: Among PWID at high risk of suicide attempt, those who binge represent a particularly vulnerable subgroup. Although the exact mechanisms underlying this finding remain unresolved, several hypothesis pertaining to the neurobiological and psychosocial consequences of binge, as well as common personality traits, warrant further investigations.

Background Occipital nerve stimulation (ONS) has been used for the treatment of neuropathic pain conditions and could be a therapeutic approach for refractory cervicogenic headache (CeH). Aim The aim of this study is to assess the efficacy and safety of unilateral ONS in patients suffering from refractory CeH. Methods We conducted a retrospective chart review on patients implanted from 2011 to 2013 at CHUM. The primary outcome was a 50% reduction in headache days per month. Secondary outcomes included change in EuroQol Group Visual Analog Scale rating of health-related quality of life (EQ VAS), six item headache impact test (HIT-6) score, hospital anxiety and depression scale (HADS) score, work status, and medication overuse. Results Sixteen patients fulfilled the inclusion criteria; they had suffered from daily moderate to severe CeH for a median of 15 years. At one year follow-up, 11 patients were responders (69%). There was a statistically significant improvement in the EQ VAS score (median change: 40 point increase, p = 0.0013) and HIT-6 score (median change: 17.5 point decrease, p = 0.0005). Clinically significant anxiety and depression scores both resolved amongst 60% of patients. At three years, six patients were responders (37.5%). Out of the 11 responders at one-year post implantation, five had remained headache responders (R-R) and one additional patient became a responder (NR-R). There was a statistically significant improvement in the EQ VAS score (median change: 15 point increase, p = 0.019) and HIT-6 score (median change: 7.5 point decrease, p = 0.0017) compared with baseline. Clinically significant anxiety and depression scores both, respectively, resolved among 22.5% and 33.9% of patients. Five out of seven disabled patients were back to work. Conclusion ONS may be a safe and effective treatment modality for patients suffering from a refractory CeH. Further study may be warranted.

Background The relationship between housing stability and drug injecting is complex, as both outcomes fluctuate over time. The objectives were to identify short-term trajectories of housing stability and injecting frequency among people who inject drugs (PWID) and examine how patterns of injecting frequency relate to those of housing stability. Methods At three-month intervals, PWID enrolled between 2011 and 2016 in the Hepatitis Cohort completed an interviewer-administered questionnaire and were tested for hepatitis C and HIV infections. At each visit, participants reported, for each of the past three months, the accommodation they lived in the longest (stable/unstable) and the number of injecting days (0–30). Group-based dual trajectory modeling was conducted to identify housing stability and injecting frequency trajectories evolving concomitantly over 12 months and estimate the probabilities of following injecting trajectories conditional upon housing trajectories. Results 386 participants were included (mean age 40.0, 82 % male). Three housing stability trajectories were identified: sustained (53 %), declining (20 %), and improving (27 %). Five injecting frequency trajectories were identified: sporadic (26 %), infrequent (34 %), increasing (15 %), decreasing (11 %), and frequent (13 %). PWID with improving housing were less likely to increase injecting (8 %) compared to those with sustained (17 %) or declining housing (17 %). Conclusions Improving housing was associated with a lower probability of increasing injecting compared to declining housing, while sustained housing stability was associated with a higher probability of increasing injecting compared to improving housing. Therefore, policies to improve PWID’s access to stable housing are warranted and may reduce, to some extent, drug injecting and related harms.

The determination of enzyme activity in the organism’s humours or in different tissues is an important means of detecting and following the evolution of numerous pathological states. In our study we have determined the activity of some cytolysis enzymes (lactate dehydrogenase, LDH; alanine-aminotransferase or glutamic-pyruvic transaminase, GPT; aspartate aminotransferase or glutamic-oxaloacetic transaminase, GOT ; creatine kinase, CK and gamma- glutamyltranspeptidase, GGT) on patients with acute coronary syndromes : angina pectoris (AP), chronic painful ischemic heart disease (CPIHD), arterial hypertension (HTN), arterial hypertension with chronic painful ischemic heart disease (HTN+CPIHD) and acute myocardial infarction (AMI). The results show that the levels of activity of cytolysis enzymes are different in patients with acute coronary syndromes (ACS). The activity of LDH, GPT, GOT, CK and GGT do not have the same values for one and the same coronary disease measured in patients from different groups of age and sexes (male and female).

Background: Meaningful reductions in Hepatitis C Virus (HCV) transmission rates among persons who inject drugs (PWID) require a comprehensive prevention approach, including access to harm reduction measures and to healthcare-related interventions, such as HCV screening, testing and antiviral treatment. Little is known, however, about the role of visiting a primary care physician (PCP) in relation to HCV infection risk among PWID, when integrated within a combined prevention approach. This study assessed the association between PCP visiting and HCV seroconversion among PWID attending needle exchange programs (NEP). Methods: A prospective cohort study, HEPCO, was conducted among active PWID in Montréal (2004-2013). Interviews scheduled at 3- or 6-month intervals included completion of an interviewer-administered questionnaire, and collection of blood samples for HCV antibody testing. HCV-seronegative participants who reported NEP attendance at baseline and had at least one follow-up visit were eligible for this study. HCV incidence was calculated using the person-time method. Time-varying Cox regression modeling was conducted to evaluate the relationship between self-reported recent PCP visiting and HCV incidence. Results: At baseline assessment, of 226 participants (80.5% male; median age: 30.6 years), 37.2% reported having recently visited a PCP. During 449.6 person-years of follow-up, 79 participants seroconverted to HCV [incidence rate: 17.6 per 100 person-years, 95% confidence interval (CI): 14.0-21.8]. Covariate-adjusted analyses indicated that visiting a PCP was associated with a lower risk of HCV infection [Adjusted Hazard Ratio: 0.54, 95% CI: 0.31-0.93]. Other independent predictors of HCV infection included unstable housing, cocaine injection and prescription opioid injection. Conclusion: Among PWID attending NEP, visiting a PCP was associated with a lower risk of HCV infection. Yet, only a minority of participants reported PCP visiting. Efforts to intensify engagement with PCP among PWID could potentially contribute to lower HCV transmission when integrated within a combined approach to prevention. Refereed/Peer-reviewed

Clinical studies have demonstrated the benefits of abiraterone acetate + prednisone (AAP) and enzalutamide (ENZ) in significantly improving survival among metastatic castration-resistant prostate cancer (mCRPC) patients. However, evidence regarding patient's real-world experience, particularly with respect to fatigue, treatment satisfaction and health-related quality of life (HRQoL) is limited. Interviews were initially conducted with patients (n = 38) and carers (n = 12) to elicit qualitative data regarding their experiences. Findings informed the design of a quantitative, multinational online survey of mCRPC patients (n = 152) receiving AAP or ENZ. Participants completed validated questionnaires assessing fatigue (Brief Fatigue Inventory), treatment satisfaction (Cancer Therapy Satisfaction Questionnaire) and HRQoL (EuroQol-5-Dimensions). Results indicated that patients were generally satisfied with these therapies, more specifically with reductions in prostate-specific antigen levels and extended survival. Fatigue was commonly linked to poor HRQoL and responses indicated that significantly fewer patients in the AAP group reported feeling usually tired or fatigued in the last week compared to the ENZ group (33% vs. 55%, p = 0.006 respectively). Findings highlight the benefit of AAP and ENZ in promoting the "quality" of extended survival. That fatigue was lower among patients receiving AAP may be important for informing treatment decisions. Further research is needed to gain deeper insights.

The pAO1 megaplasmid of A. nicotinovorans consists of 165 ORF's related mainly to nicotine degradation, uptake and utilization of carbohydrates, amino acids and sarcosine. A putative sugar catabolic pathway consisting of 11 ORF's organized as a single operon were previously described. The current work brings experimental data supporting the existence of a D-Xylose catabolic pathway on the pAO1 megaplasmid. When grown on D-xylose containing media, the cells harboring the pAO1 megaplasmid grow to higher cell densities and also express the OxRe protein coded by the megaplasmid. A putative pathway similar to Weimberg pentose pathway is postulated, in which D-xylose is transported in the cell by the ABC-type transport system and then transformed using the putative sugar-dehidrogenase OxRe to D-xylonate, which is further degrated to 2-ketoglutarate and integrated into the general metabolism of the cell

More and more attention has been given lately to the cardiac Troponin, which have great importance in regulating the contractility of the cardiac muscle. An increase in the Troponin levels can surely serve both for the diagnosis as well as for the prognosis of an acute myocardial infarction AMI. The increase of these AMI markers appears in 3-4 h and can last up to 3-4 weeks. This study has dealt with the comparison of the cTnI levels in the case of AMI for three age categories: 36-50, 51-65 and over 65 years old, both for female and male subjects, as well as with the comparison of the cTnI levels of the two sexes. We have included in the study a number of 65 patients, 20 females and 45 males, which were hospitalized in the cardiology department of Bacau County Hospital during 2008-2011. The device used for the measurements was the Pathfast immuno-analyzer. Statistical univariate analyses were used to compare the cTnI levels by age, group and gender. As far as we know it, such a comparative study has never been done. The biochemical results that have been obtained showed that the level of the I Troponin was significantly higher with the male patients for the categories of 36-50 and 51-65 years old. With the 36-50 years old category, the average Troponin value was 2 g/L and for the 51-65 category, the average value was 2.3 g/L. Females have a higher predisposition to complications that may arise as a result of myocardial necrosis in old age, over 65 years. Kruskal Wallis Values test results confirm a greater differentiation between age groups: men (.2 = 21.461, df = 3, p

Review on GHEORGHE HRINCĂ - Grupele sanguine la ovine Editura Agata, Botoşani, 2012

The pAO1 megaplasmid of A. nicotinovorans consists of 165 ORF\'s related mainly to nicotine degradation, uptake and utilization of carbohydrates, amino acids and sarcosine The putative sugar catabolic pathway consists of 11 ORFś organized as a single operon and coding for an ABC-type sugar-transport system and several putative oxidoreductases and dehydrogenases. The current work is focused on orf32, a putative PdhR related protein, most probably involved in the control of the whole operon. The approx. 700 kb orf32 gene was cloned in the pH6EX3 plasmid vector and the gene product purified to homogeneity as a 29 kDa His-tagged recombinant protein. As indicated by GPC, it consists of a monomeric protein with a native molecular weight of 32 kDa. The specific UV/Vis spectra showed only a single peak at 280 nm common for all proteins and did not indicated the presence of any colored cofactors. This is in good agreement with the fact that PdhR-family proteins contain a winged helix-turn-helix (wHTH) domain responsible for DNA binding, and not a Zn-finger or any other metal containing domains

Entrepreneurs do not form a homogeneous set who can be distinguished from non-entrepreneurs on the basis of their personality characteristics. In Romania, the Small and Medium Enterprises (SMEs) have a young history of 19 years behind. The present paper aims to outline the profile of the Romanian entrepreneur and to analyze the compatibility between the features of the entrepreneur’s behavior and those required by a Learning Organization. The results are based on a study performed in February and March 2009 on a sample of 200 respondents from different regions of the country and indicate a high potential for SMEs development in Romania.

The stress response is mediated by the hypothalamo-pituitary-adrenal (HPA) system. Activity of the hypothalamic paraventricular nucleus (PVN) forms the basis of the HPAaxis. Behavioral and endocrine responsivity to threat and their ontogenetic changes may be mediated by PVN. Methods. 6-hydroxydopamine (6-OHDA) remains the most widely used substance in animal models for inducing highly reproducible brain lesions. In our study, parvocellular neurons from the PVN of male Wistar rats were chemical lesioned by right-unilateral stereotaxic injection of two different doses of 6-OHDA (8µg/3µl and 16µg/3µl) and were subjected to a battery of behavioral tests designed to assess spatial memory formation (radial arm-maze task) and anxiety (elevated plus maze). Further, we were interested in knowing whether a 6-OHDA lesion of the PVN would result in an imbalance in neuronal oxidative stress levels. Results. 6-OHDA-induced PVN lesions significantly increased the number of working memory errors, suggesting effects on short-term memory, without affecting longterm memory, explored by number of reference memory errors in radial arm-maze task. In elevated plus maze measuring anxiety, 6-OHDA significantly diminished anxiety-like behavior in a dose-dependent manner. In addition, the neurotoxin induced a reduction in superoxide dismutase (SOD) and glutathione peroxidase (GPX) specific activities, while malondialdehyde (MDA) level was found increased in the temporal lobe of rat brain, the most vulnerable cortical area to oxidative stress effects. Conclusion. Results suggest that 6-OHDA lesion of the PVN affects behavioral performance via interactions with systems governing arousal level and possibly by increasing neuronal oxidative stress.

Male Wistar rats were subjected to right-unilateral 6-hydroxydopamine (6-OHDA) (2 μg/μl) lesions of the ventral tegmental area (VTA) or the substantia nigra (SN), or were sham-operated, and their ability to acquire the operant task was studied by means of Y-maze and shuttle-box tasks. Lesions of both the VTA and the SN resulted in an impairment of conditioned avoidance response and increase of crossing latency tested by means of shuttle-box task, suggesting significant effects of long-term memory. 6-OHDA significantly decreased spontaneous alternation in Y-maze task, suggesting effects on spatial memory, especially on short-term memory. In addition, 6-OHDA lesions of the VTA and the SN induced reductions in superoxide dismutase (SOD), glutathione peroxidase (GPX) activities and malondialdehyde (MDA) levels in the temporal lobe rather than in the frontal lobe homogenates. Our results provide further support for the toxic effects of 6-OHDA-induced memory impairment and oxidative stress with relevance for Parkinson’s disease.

The high density of the steroid hormone receptors in the structures of temporal lobe involved in learning and memory, such as the hippocampus, perirhinal cortex, entorhinal cortex and amigdaloid complex, shows that there must be a direct relationship between gonadal hormones and organizational effects of steroid hormones in those structures during development of the nervous system. The present study was undertaken in order to investigate the effect of testosterone administration during the third week of gestation on the spatial memory formation of the offspring rats and the level of soluble proteins in the temporal lobe and frontal lobe of brain, as evidence of important organizational effects of androgens during prenatal development in brain sexual dimorphism. Animals have received testosterone undecanoate on days 14, 15, 16 and 19, 20, 21 of gestation. Learning and memory tests were started 100 days after the testosterone treatment. At the end of the experiments, the temporal and frontal lobes of brain were removed for assessing the level of soluble proteins. Testosterone treatment significantly improved spontaneous alternations percentage of male offspring in Y-maze task comparative with female offspring and reference memory in radial 8 arm-maze task (decreasing in number of reference memory errors in both male and female offspring groups), suggesting effects of both short and long-term memory. Also, testosterone significantly increased the brain soluble protein level of treated female rats in 14–16 prenatal days compared with the control group as well as the brain soluble protein level of treated male rats. These results suggest that steroid hormones play an important role in the spatial learning and memory formation by means of protein synthesis in different lobes of the brain.

An NAD(P)H-nicotine blue (quinone) oxidoreductase was discovered as a member of the nicotine catabolic pathway of Arthrobacter nicotinovorans . Transcriptional analysis and electromobility shift assays showed that the enzyme gene was expressed in a nicotine-dependent manner under the control of the transcriptional activator PmfR and thus was part of the nicotine regulon of A. nicotinovorans . The flavin mononucleotide-containing enzyme uses NADH and, with lower efficiency, NADPH to reduce, by a two-electron transfer, nicotine blue to the nicotine blue leuco form (hydroquinone). Besides nicotine blue, several other quinones were reduced by the enzyme. The NAD(P)H-nicotine blue oxidoreductase may prevent intracellular one-electron reductions of nicotine blue which may lead to semiquinone radicals and potentially toxic reactive oxygen species.

Background Psychiatric problems and cocaine use are associated with heightened vulnerability for HIV and Hepatitis C infections. Little is known regarding the relationship between psychiatric symptoms, psychiatric diagnoses and injection risk behaviors among cocaine users. We examined the association between psychological distress and injection material sharing among cocaine users, while accounting for comorbid anxious and mood disorders. Methods Participants included cocaine users who inject drugs recruited in a prospective cohort study in Montreal, Canada. Diagnosis of mood and anxiety disorders in the year preceding baseline were established using the Composite International Diagnostic Interview (CIDI) questionnaire. Psychological distress based on the Kessler scale and injection material sharing in the past 3 months were assessed at baseline and at each of the five follow-up visits at 3-month intervals. Statistical analyses were conducted using generalized estimation equation. Results Of the 387 participants (84.5% male; 80.1%, ≥ 30 y.o.), 35% reported severe psychological distress, 43% qualified for an anxiety disorder diagnosis and 29% for a mood disorder diagnosis at baseline. Psychological distress was not associated with any injection risk behavior when adjusting for socio-demographic and psychiatric disorders. Participants with anxiety disorders were more likely to share needle (adjusted odds ratio: 1.89, 95% CI: 1.17–3.03). Sharing of injection material other than needle was not associated with psychiatric disorders or with psychological distress in multivariate analyses. Conclusions Anxiety disorders are associated with needle sharing among cocaine users. Our results suggest the importance of screening for anxiety disorders as part of preventive interventions to decrease blood-borne viruses' transmission.

To estimate associations between recent licit and illicit substance use and subsequent suicide attempt among people who inject drugs (PWID).Secondary analysis of longitudinal data from a prospective cohort study of PWID followed bi-annually between 2004 and 2011.Montréal, Canada.Seven hundred and ninety-seven PWID who reported injection drug use in the previous 6 months, contributing to a total of 4460 study visits. The median number of visits per participant was five (interquartile range: 3-8).An interviewer-administered questionnaire eliciting information on socio-demographic factors, detailed information on substance use patterns and related behaviours, mental health markers and suicide attempt. The primary exposure variables examined were past-month use of alcohol [heavy (≥ 60 drinks); moderate (one to 59 drinks); none], sedative-hypnotics, cannabis, cocaine, amphetamine and opioids [regular (≥ 4 days); occasional (1-3 days); none]. The outcome was a binary measure of suicide attempt assessed in reference to the previous 6 months.In multivariate analyses, a positive association was found among licit substances between heavy alcohol consumption [adjusted odds ratio (AOR) = 2.05; 95% confidence interval (CI) = 1.12-3.75], regular use of sedative-hypnotics (AOR = 1.89; 95% CI = 1.21-2.95) and subsequent attempted suicide. Among illicit substances, occasional use of cannabis (AOR = 1.84; 95% CI = 1.09-3.13) had a positive association with subsequent suicide attempt. No statistically significant association was found for the remaining substances.Among people who inject drugs, use of alcohol, sedative-hypnotics and cannabis, but not cocaine, amphetamine or opioids, appears to be associated with an increased likelihood of later attempted suicide.

Background While the elevated risk of suicide attempt among persons who inject drugs (PWID) is well documented, whether use of different substances is associated with varying degrees of risk remains unclear. We sought to examine the associations between substance use patterns and attempted suicide in a prospective cohort of PWID in Montreal, Canada. Methods Between 2004 and 2011, participants completed an interviewer-administered questionnaire eliciting information on socio-demographics, substance use patterns, related behaviors, and mental health markers. Generalized estimating equations were used to model the relationship between self-reported use of six common substances (cocaine, amphetamine, opioids, sedative-hypnotics, cannabis and alcohol), associated patterns of use (chronic, occasional and none), and a recent (past six-month) suicide attempt. Results At baseline, of 1240 participants (median age: 39.1, 83.7% male), 71 (5.7%) reported a recent suicide attempt. Among 5621 observations collected during follow-up, 221 attempts were reported by 143 (11.5%) participants. In multivariate analyses adjusting for socio-demographics and psychosocial stressors, among primary drugs of abuse, chronic [adjusted odds ratio (AOR): 1.97] and occasional (AOR: 1.92) cocaine use, and chronic amphetamine use (AOR: 1.96) were independently associated with attempted suicide. Among co-used substances, chronic sedative-hypnotic use was independently associated with an attempt (AOR: 2.29). No statistically significant association was found for the remaining substances. Conclusion Among PWID at high risk of attempted suicide, stimulant users appear to constitute a particularly vulnerable sub-group. While the mechanisms underlying these associations remain to be elucidated, findings suggest that stimulant-using PWID should constitute a prime focus of suicide prevention efforts.

Although the ability of Bifidobacterium spp. to grow on fructose as a unique carbon source has been demonstrated, the enzyme(s) needed to incorporate fructose into a catabolic pathway has hitherto not been defined. This work demonstrates that intracellular fructose is metabolized via the fructose-6-P phosphoketolase pathway and suggests that a fructokinase (Frk; EC 2.7.1.4) is the enzyme that is necessary and sufficient for the assimilation of fructose into this catabolic route in Bifidobacterium longum . The B. longum A10C fructokinase-encoding gene ( frk ) was expressed in Escherichia coli from a pET28 vector with an attached N-terminal histidine tag. The expressed enzyme was purified by affinity chromatography on a Co 2+ -based column, and the pH and temperature optima were determined. A biochemical analysis revealed that Frk displays the same affinity for fructose and ATP ( K m fructose = 0.739 ± 0.18 mM and K m ATP = 0.756 ± 0.08 mM), is highly specific for d -fructose, and is inhibited by an excess of ATP (>12 mM). It was also found that frk is inducible by fructose and is subject to glucose-mediated repression. Consequently, this work presents the first characterization at the molecular and biochemical level of a fructokinase from a gram-positive bacterium that is highly specific for d -fructose.

In the last 30 years, many biochemistry and neuroscience studies elucidated the main aspects of the acetylcholine metabolism, including proteins responsible for the biosynthesis, storage, release and degradation of acetylcholine. In this review, some data about the precursors implicated in acetylcholine biosynthesis and about some characteristics of cholinergic system enzymes, choline acetyltransferase and acetylcholinesterase, will be discussed.

Sneddon syndrome is defined by the association of livedo racemosa and recurrent cerebrovascular ischemic lesions. The annual incidence is 4/1,000,000. This syndrome particularly affects young women, some reports suggesting a family predisposition. It is a chronic, progressive, arterio-occlusive disease of unknown etiology that involves small and medium-sized arteries. It is usually associated with antiphospholipid antibodies. We report the case of a female patient with Sneddon syndrome with significant family history, personal history of stroke, epilepsy, migraine, cardiovascular involvement, three miscarriages, cognitive decline, noncompliant to therapy, in the absence of antiphospholipid antibodies. This paper aims to analyze the main characteristic features and management of Sneddon syndrome by conducting a literature review related to a clinical case.

Summary The role of primary care physicians (PCP) in hepatitis C virus (HCV) prevention is increasingly emphasized. Yet, little is known about the patterns of contacts with PCP among persons who inject drugs (PWID). We sought to assess the 6-month prevalence of PCP visiting among PWID at risk of HCV infection and to explore the associated factors. Baseline data were collected from HCV-seronegative PWID recruited in HEPCO, an observational Hepatitis Cohort study (2004–2011) in Montreal, Canada. An interviewer-administered questionnaire elicited information on socio-demographic factors, drug use patterns and healthcare services utilization. Blood samples were tested for HCV antibodies. Using the Gelberg-Andersen Behavioral Model, hierarchical logistic regression analyses were conducted to identify predisposing, need and enabling factors associated with PCP visiting. Of the 349 participants (mean age = 34; 80.8% male), 32.1% reported visiting a PCP. In the multivariate model, among predisposing factors, male gender [adjusted odds ratio (AOR) = 0.45 (0.25–0.83)], chronic homelessness [AOR = 0.08 (0.01–0.67)], cocaine injection [AOR = 0.46 (0.28–0.76)] and reporting greater illegal or semi-legal income [AOR = 0.48 (0.27–0.85)] were negatively associated with PCP visits. Markers of need were not associated with the outcome. Among enabling factors, contact with street nurses [AOR = 3.86 (1.49–9.90)] and food banks [AOR = 2.01 (1.20–3.37)] was positively associated with PCP visiting. Only one third of participating PWID reported a recent visit to a PCP. While a host of predisposing factors seems to hamper timely contacts with PCP among high-risk PWID, community-based support services may play an important role in initiating dialogue with primary healthcare services in this population.

Wistar rats were treated 6, 13 and 20 days with two type electromagnetic field (EMF): 50Hz and 100Hz, 30 minute daily. It was determined superoxide dismutase and glutathione peroxidase activities in rat blood serum treated with EMF. Confronted by control lot, in both 50Hz and 100Hz EMF treated animals the superoxide dismutase activity is increasing after 6 and 13 day of treatment. At 20 days it was recorded a superoxide dismutase activity inhibition, greater than the 100Hz EMF treatment. The blood serum glutathione peroxidase activity was stimulated by 50Hz EMF after 6 days and also by 50Hz and 100Hz EMF after 13 day of treatment. The 20 days treatment (long duration) was determined an insignificant inhibition of glutathione peroxidase.

Oxidative stress has an important role in genesis of diabetic complications, especially diabetic nephropathy. The aim of the study was to assess correlations between increase of oxidative stress (OS) and the development of microalbuminuria (MA) in type 1 diabetic patients. We determined the oxidative status by measuring the level of superoxide dismutase (SOD-Minanui method), catalase (CAT-Aebi method), glutathione peroxidase (GPx-Fukuzawa method) and glutathione (GSH-Ellman method) in 87 type 1 diabetic patients (44 with normal urinary protein excretion-group A and 43 with MA-group B) and 38 nondiabetic matched controls, before and 24 hours after a test effort. The results of the study point out that a decreased in activity of SOD or in levels of GSH is associated with an increased MA in type 1 diabetic patients.

It is known that high sanguin levels of cholesterol and LDL-cholesterol (LDLc) have an important role in the pathogenesis of atherosclerosis. The treatment of hypercholesterolemia with statins and/or with fibrates have had beneficial effects on coronary heart disease and on other localization of atherosclerosis. The decreased of cholesterol and LDL-cholesterol is the most important effect of this treatment. The epidemiological studies have revealed that the treatment with statins and/or with fibrates produce an increase of HDL-cholesterol (HDLc), which is also very important in the regression of atherosclerosis. We tried in this review to explain the mechanisms of the increase of HDL-cholesterol, in concordance with the data from literature.

Fibrates are hypolipemic agents used in noninsulin dependent diabetes mellitus (NIDDM) because these drugs have no influence on glycemia control. The efficiency of fenofibrate (Lipanthyl) was studied in a group of 22 subjects, 30-70 years, obese (body mass index-BMI over 30 kg/m2) or overweight (BMI = 28-30 kg/m2) with hypertension or/and diabetes. All the patients received 200 mg fenofibrate daily, for 6 month, and they had a hypocaloric diet. We measured seric lipids. The results were compared with a control group (20 normal subjects). Under treatment, atherogenic lipids (total cholesterol, LDL-cholesterol and triglycerides) had significantly decreased (p0.05) and antiatherogenic fraction (HDL-cholesterol) significantly increased (p0.05) compared to initial values. In the mean time, the BMI has significantly decreased under fenofibrate treatment, this body mass loss having a positive influence on lipid metabolism. We observed a better therapeutically response in obese patients vs. the overweight ones, probably due to a higher prevalence of the hypertension in the second subgroup. In conclusion fenofibrate is the drug which can be choose in diabetic dyslipidemia without cardiac disease.

Methylglyoxal (MG) is an early glycation product which is implicated in genesis of diabetic complications either as a direct toxin or as a precursor for advanced glycation end products. It is metabolized via S-D-lactoylglutathione to D-lactate by means of the enzymes glyoxalase I and II, which depend on glutattione as cofactor. MG is highly reactive and can bind to and modify proteins by chemical interaction with cellular proteins, action on energy production, induce free radical generation and cell killing. That way MG play a role in the events of the development of diabetic complications.

It is known that high sanguin levels of cholesterol and LDL-cholesterol (LDLc) have an important role in the pathogenesis of atherosclerosis. The treatment of hypercholesterolemia with statins and/or with fibrates have had beneficial effects on coronary heart disease and on other localization of atherosclerosis. The decreased of cholesterol and LDL-cholesterol is the most important effect of this treatment. The epidemiological studies have revealed that the treatment with statins and/or with fibrates produce an increase of HDL-cholesterol (HDLc), which is also very important in the regression of atherosclerosis. We tried in this review to explain the mechanisms of the increase of HDL-cholesterol, in concordance with the data from literature.

The objective of this study is to reveal the deterioration of the systolic and diastolic function of the left ventricle (LV) in patients with diabetes mellitus (DM), in correlation with type of DM, the edge and the complications of DM and the associated diagnosis.The study included 43 patients with DM (29 patients with DM type 1 or 2 insulinodependent--DMID and 14 patients with DM type 2 nonisulinodependent--DMNID). The age of patients was between 21 years and 57 years, with a duration of DM between 1 year and 22 years. The ecocardiographic evaluation have determined 38 parameters (B mod, M mod, CWD, PWD, colour Doppler). From these parameters, 12 was used for the measurement of the systolic function of the LV and 18 was used for the determination of the diastolic function of the left ventricle. The clinical and biological exam have performed: glycaemia, proteinuria, dyslipidemic syndrome, complications of DM and ischaemic heart disease (ECG).The ejection fraction (EF) of the LV was ?60% in 23 patients, between 50% and 60% in 17 patients and between 40% and 50% in 3 patients. The values of MSER (mean systolic ejection rate) was between 221 ml/s şi 515 ml/s and the values of MVCF (mean velocity of circumferential shortening) was between 0.9 circ/s şi 1, 8 circ/s. The ratio of the E and A waves at the mitral valve was1 in 22 patients and1 in 21 patients. The LV isovolumic relaxation time (IVRT) was70 ms in 13 patients,100 ms in 14 patients and had normal values in 16 patients. The E wave deceleration time (EDT) was150 ms in 24 patients and had normal values in 19 patients. There is no connection between the systolic/diastolic function and the other determined parameters.The alteration of the LV systolic function was present in 20 patients from 43 patients. The LV diastolic dysfunction through relaxation troubles was present in 14 patients and the LV diastolic dysfunction through compliance trouble was present in 13 patients. A number of 16 patients had preserved (for the moment) a normal LV diastolic function. The number of patients with these two types of LV diastolic dysfunction was equal in our study. Other studies had found a predominance of LV diastolic dysfunction through compliance troubles in DM.