Barriers to HIV and Hepatitis C care for people who inject drugs in Colombia.

People who inject drugs (PWIDs) are a key population targeted in global efforts to increase HIV and Hepatitis C virus (HCV) diagnosis, linkage to care, and treatment retention. Colombia has experienced a significant increase in the incidence of HIV and HCV attributed to the alarming rise in injection drug use. The primary aim of this study was to identify factors influencing access to HIV and HCV care among PWIDs. Survey domains consisted of (1) sociodemographic characteristics; (2) history of HIV-HCV testing and infection status; (3) the 13-item questionnaire developed by Awad and colleagues to explore barriers to HIV and HCV testing, (4) the Barriers to Medical Care questionnaire; and (5) the Risk Assessment Battery. A total of 171 subjects completed the survey. A high proportion of participants reported past year testing for HIV (87%) and HCV (72.8%). However, most respondents elicited numerous barriers to obtaining information, referrals, and insurance coverage for accessing HIV and/or HCV care. Further studies are needed to identify scalable public health measures to overcome these barriers.

Pregnancy-adapted uterine artery endothelial cell Ca2+ signaling and its relationship with membrane potential.

Pregnancy-derived uterine artery endothelial cells (P-UAEC) express P2Y2 receptors and at high cell density show sustained and synchronous [Ca2+]i burst responses in response to ATP Bursts in turn require coupling of transient receptor potential canonical type3 channel (TRPC3) and inositol 1,4,5-triphosphate receptor type 2 (IP3R2), which is upregulated in P-UAEC in a manner dependent on connexin 43 (Cx43) gap junctions. While there is no known direct interaction of TRPC3 with Cx43, early descriptions of TRPC3 function showed it may also be influenced by altered membrane potential (Vm). Herein, we ask if enhanced TRPC3 Ca2+ bursting due to enhanced Cx43 coupling may be coupled via dynamic alterations in Vm in P-UAEC, as reported in some (HUVEC) but not all endothelial cells. Following basic electrical characterization of UAEC, we employed a high sensitivity cell imaging system to simultaneously monitor cell Vm and [Ca2+]i in real time in continuous monolayers of UAEC Our findings show that while acute and sustained phase [Ca2+]i bursting occur dose-dependently in response to ATP, Vm is not coregulated with any periodicity related to [Ca2+]i bursting. Only a small but significant progressive change in Vm is seen, and this is more closely related to overall mobilization of Ca2+. Surprisingly, this is also most apparent in NP-UAEC > P-UAEC In contrast [Ca2+]i bursting is more synchronous in P-UAEC and even achieves [Ca2+]i waves passing through the P-UAEC monolayer. The relevance of these findings to mechanisms of pregnancy adaptation and its failure in hypertensive pregnancy are discussed.

Magnetic resonance imaging in patients with recently implanted pacemakers.

BACKGROUND: Recent studies have shown that magnetic resonance imaging (MRI) of patients with pacemakers can be safely performed under careful monitoring, but they excluded patients with recently implanted devices. Patients with recent implants may be at a greater risk for complications during MRI imaging due to lack of lead and wound maturity. METHODS: We implemented a clinical protocol for MRI imaging of patients with implanted cardiac devices, and prospectively collected data. For this study, we retrospectively analyzed two groups of patients: those with recently implanted (≤42 days) and nonrecently implanted (>42 days) leads at the time of MRI scanning. All devices were interrogated before and after scanning, and were reprogrammed during the scan as per protocol. RESULTS: Of the 219 scans (in 171 patients), eight included patients with recently implanted (range: 7-36 days) and 211 with only nonrecently implanted pacemaker leads. During the scan, there were no complications in the early or late group. In one patient imaged 79 days postimplant, frequent premature ventricular complexes were noted during the scan, requiring no action. No patient reported pain during or immediately after the procedure. No clinically significant changes in function were seen at subsequent follow up (average 104 days post-MRI). Compared to patients with nonrecently implanted leads, there was no difference in any parameter between the two groups. CONCLUSIONS: With a strong clinical indication and with careful monitoring, MRI imaging is feasible in patients with recently implanted pacemakers, although experience is limited.