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Although Hepatitis C virus (HCV) infection has become a curable disease, the aftermath of the infection remains an important aspect to be evaluated. HCV infection is well known for its extrahepatic manifestations, mostly the tight relationship between HCV, type 2 diabetes mellitus (T2DM) and dyslipidemia. Not only HCV increases the risk of T2DM, but it also affects its control in diabetic patients, increasing the risk of diabetes related complications. Furthermore, HCV hijacks the lipid metabolism resulting in abnormalities in circulating lipids which can lead to multiple complications, such as increased atherosclerotic risk and hepatic steatosis. Objectives. The aim of this study was to evaluate the dynamics of the parameters of carbohydrate and lipid metabolism in HCV-infected diabetic patients compared to non-diabetic patients after viral eradication. Material and methods. This is a prospective study conducted on 100 patients with chronic HVC infection who obtained viral clearance after interferon-free treatment. 58 patients had type 2 diabetes mellitus and 42 were nondiabetic. We evaluated serum total cholesterol, triglycerides, blood glucose and glycosylated hemoglobin in both groups at treatment initiation and 1 year after. Continuous variables were expressed as mean values ± standard deviation or median, categorical variables were represented as relative or absolute frequencies. Characteristics were compared using the Mann-Whitney method or the two-sample Student's T-test method for continuous variables, Chi-square and Fischer's test for categorical variables. A p value < 0.05 was considered statistically significant. Outcomes. The study analyzed and compared lipid and glycemic profiles of diabetic and non-diabetic HVC patients before and after viral cure. Conclusions. 1 year after treatment initiation the changes in lipid metabolism seem to persist, carbohydrate metabolism seems to remain unchanged, with no differences between diabetic and non-diabetic patients.

Introduction. COVID-19 is a viral infection with a variable clinical spectrum, ranging from asymptomatic carrier state to severe pneumonia. It is associated with a variety ofcomplications, including musculo-skeletal abnormalities. Whereas myalgia is a common clinical finding at these patients, only a few cases of COVID-19-associated rhabdomyolysis have been described in the literature. Case presentation. We describe the case of a 42-year old male confirmed with SARS-CoV-2 infection who presented to the emergency department with an 11-day evolution of dyspnea, cough, fatigue, myalgia and hyperchromic urine. The psysical examniation revealed dyspnea and an oxigen saturation of 87% while breathing ambient air, being otherwise normal. Blood tests showed neutrophilia, increased inflammatory markers, COVID-19 associated coagulopathy and elevation of muscular enxymes creatine-kinase and myoglobin. The chest computer tomography was consistent with mixed pneumonia, distributed in all pulmonary segments and the case was interpreted as a severe form of SARS-CoV-2 infection, associated with acute respiratory failure and rhabdomyolysis. Upon treatment (Enoxaparin, Aspirin, Dexamethasone, Favipiravir, oxygen administered by face mask, fluid resuscitation), his condition considerably improved, along with the laboratory findings, and he was discharged, without developing acute kidney injury or other complications related to rhabdomyolysis during his admission. Conclusion. COVID-19 patients can develop rhabdomyolysis, which can result in life-threating complications.

Traveler’s diarrhea (TD) is an acute, self-limited disease, caused by a wide array of germs that possess intestinal tropism. Among the 12 million people travelling annually to tropical or subtropical areas, 30% up to 70% are affected by TD. A single episode of diarrhea can severely impair, sometimes severe, the performance of special categories of travelers, like sportsmen, business people, or diplomats in specific missions. The disease has an equal distribution among sexes, occurring with a higher frequency among the youth. The Enterotoxigenic E.coli is the main pathogen incriminated in 80 to 90% of TD’cases.Recent international infectious disease or traveler medicine guidelines are recommending Rifaximine-α(RFX) as the first therapeutical option with the highest level of recommendation and evidence (IA) in treating or preventing non-invasive forms of TD. The normal daily dosage in these cases is 800 mg of RFX for at least 3 days. RFX is a non-absorbable (intestinal) antibiotic which has clinically proven its high rate of success regarding its safety and efficacy in treating and preventing TD. Referring to TD’s prevention, it must be mentioned that even though antibiotic prophylaxis is not routinely recommended while travelling (at least in cases of more than 3 weeks of travel), this approach should be serious taken into consideration for several types of high risk traveler patients who present at least one of the following conditions: immunodeficiency, chronic inflammatory intestinal diseases, kidney failure or diabetes mellitus. But even there are or not real reasons in recommending antibiotic prophylaxis, Rifaximine-α should not miss from any personal first-aid traveler-kit.