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Background. Shared decision making (SDM) is becoming more and more important for the patient-physician interaction. There has not been a study in Romania evaluating patients’ point of view in the SDM process yet. Therefore, the present study aims to evaluate the psychometric parameters of the translated Romanian version of SDM-Q-9.

Canine babesiosis is an emerging tick-borne disease of major veterinary concern in Europe. Its prevalence has increased in the last two decades and is spreading rapidly toward the north. The aim of this study was to investigate the genetic diversity of Babesia spp. strains isolated from naturally infected dogs in a tick-endemic area (Dobrogea) in southeastern Romania. For this purpose, a total of twenty-three samples from dogs diagnosed with various clinical forms of babesiosis, evaluated by means of clinical history, physical examination, and hematological tests, were subjected to a molecular investigation using PCR, sequencing analysis, and genetic characterization. A microscopic examination of thin Diff-quick-stained blood smears revealed large intra-erythrocytic Babesia piroplasms in all dogs. The PCR and sequencing analysis results indicated the presence of Babesia canis in 22 dogs (95.7%) and Babesia vogeli in 1 dog (4.3%). Among the B. canis isolates, two genotypes were distinguished based on two nucleotide substitutions (GA→AG) observed in the 18S rRNA gene sequences (at positions 609 and 610), with the AG genotype predominating (54.5% of samples), while the GA variant was identified in 9.1% of samples. In the remaining isolates (36.4%), both variants were identified. The B. vogeli -positive dog also tested positive for antibodies against Ehrlichia canis and displayed severe disease. This study reports, for the first time, the presence of genetically heterogenic B. canis strains in dogs with clinical babesiosis in Romania. These findings provide a basis for future studies on the relationship between the genetic structure of the causative agents of canine babesiosis in Romania and the course of the disease.

Background: Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM., Material and Methods: A cross-sectional multicentric study comprising eight recruitment centres was performed. Inpatients and outpatients who referred to Hospital Units treating autoimmune diseases or atrial fibrillation were included. Another sample consisted of members of the Autoimmune Disease Patient Society, who completed an online anonymous questionnaire. All participants completed the Romanian translated version of the 9-item Shared Decision Making Questionnaire (SDM-Q-9), as these samples were used for the validation of this questionnaire, too. Patients had to refer to the visit in which the decision concerning the antithrombotic treatment was taken (atrial fibrillation patients), or the immunosuppressive treatment was last time changed (autoimmune disease patients). Ordinal regression having the total SDM score as dependent variable was used., Results: A total of 665 questionnaires were filled in within the hospital setting (n = 324; 48.7%) and online (n = 341; 51.3%). The median score for SDM was 34 of 45, but it differed between hospital completion -39/45 and online completion (anonymous) -20/45 (P < .001). Patients with higher education were influenced most by the setting, giving the best marks in hospital and low marks online, while those with lower education gave lower marks in both settings. In ordinal regression with SDM score as dependent variable, hospital completion of the questionnaire (OR = 9.5, 95% confidence interval, 5.69-16), collagen disease diagnosis (OR = 2.4, 95% confidence interval, 1.39-4.14), and immunosuppressive treatment (OR = 2.16, 95% confidence interval, 1.43-3.26) were independent predictors., Conclusion: In our study, full anonymity was associated with significantly lower scores for the SDM process. The patients with higher education were most influenced by this condition, while those with the lowest education were the most critical., (© 2019 John Wiley & Sons, Ltd.)

In this study the conventional oils used for lipid nanocarriers (NLCs) synthesis were replaced by high concentration of fish oils (e.g., fish oil concentrated in omega-3 fatty acids, fish oil enriched in omega-3 and omega-6 fatty acids and salmon oil), in order to produce appropriate lipid based nanosystems able to entrap willow bark extract (WBE). Formulation factors such as the nature of the fish oil, glycerol content and WBE loading were evaluated to produce optimum lipid based nanosystems with suitable physical stability and enhanced antioxidant activity. The synthesized WBE-NLC showed spherical and homogeneous particles and average diameters in the range of 200-250 nm, as determined by TEM measurements. The electrokinetic potentials were negative for all free- and WBE-loaded NLCs, with values between -29.1 ÷ - 35.8 mV, which reveal an excellent physical stability. By scanning calorimetry measurements it has been shown that the lipid crystallization and melting behavior of NLCs before and after loading with WBE were no significantly influenced by the type of fish oil used and only in a few NLCs formulations an obvious perturbation of lipid network have been detected. The chemiluminescence technique has been used to assess the effect of fish oil type on the in vitro antioxidant activity of WBE-NLCs. Ability of WBE entrapped within NLCs to scavange the free radicals was greater than for native WBE and fish oils. The difference between the antioxidant activity of WBE-NLC (98%) and those of pure WBE (AA% = 77.2) and fish oil (AA% = 83.7), may be explained by the occurrence of a synergistic effect between the components of lipid nanocarriers.