L’ABC des fiducies entre vifs : aspects civils et fiscaux

Reproduit avec l'autorisation de la Chambre des notaires du Québec[À l'origine dans / Was originally part of : Fac. Droit - Coll. facultaire - Droit privé - Famille et personnes]Version acceptée / Accepted Manuscrip

Association between neighbourhood socioeconomic characteristics and high-risk injection behaviour amongst injection drug users living in inner vs. other city areas in Montréal, Canada

Ce manuscrit est une pré-publication d'un article paru dans International Journal of Drug Policy 2010; 21(1): 49-55.IRSC et FRSQ - Réseau SIDA et maladies infectieuse

Cannabis use correlates of syringe sharing among injection drug users

Ce manuscrit est une pré-publication d'un article paru dans The American Journal on Addictions 2010; 19(3): 231-237 url: http://onlinelibrary.wiley.com/doi/10.1111/ajad.2010.19.issue-3/issuetocIRSC et FRSQ - Réseau SIDA et maladies infectieuse

Gender-Specific Situational Correlates of Syringe Sharing during a Single Injection Episode

Ce document est la pré-publication d'un article paru dans AIDS and Behavior 2011; 15(1): 75-85 url: http://link.springer.com/journal/volumesAndIssues/10461IRSC et FRSQ Réseau SIDA et maladies infectieuse

Neurobiologie de la toxicomanie : avancées récentes et nouvelles stratégies d’intervention

Pendant longtemps, la toxicomanie a été associée sur le plan neurobiologique à la modulation à court terme de différents systèmes de neurotransmission. Les stratégies de traitement ciblaient conséquemment les récepteurs auxquels se lie directement la substance étant source d’abus. Ces approches ont contribué à améliorer le soulagement des symptômes d’intoxication et de sevrage, tout en favorisant l’accès à des services psychosociaux adaptés. Toutefois, les données soulignent, chez certains sous-groupes d’individus, l’efficacité parfois mitigée de ces interventions visant à diminuer de façon soutenue la consommation et les symptômes associés à la toxicomanie, particulièrement le craving. Les avancées récentes en neurosciences ont permis de mieux comprendre les mécanismes neurobiologiques expliquant la vulnérabilité à la rechute. D’une conception essentiellement dopaminergique et striatale, les théories biologiques de la toxicomanie intègrent maintenant la contribution des systèmes glutamatergique, opioïde et endocannabinoïde, de même que l’interaction entre ces différentes composantes au sein des structures corticales et sous-corticales. L’intérêt semble avoir migré des phénomènes neurobiologiques à court terme vers la modulation prolongée du fonctionnement des structures en jeu dans la toxicomanie. Ce changement de paradigmes a mené à l’émergence de plusieurs stratégies thérapeutiques visant à diminuer les risques de rechute en modulant de façon plus spécifique les circuits neuronaux dont le fonctionnement est altéré par la prise chronique de substances. Les systèmes endocannabinoïde et glutamatergique, notamment, apparaissent comme une cible de choix pour le traitement du craving et la prévention de la rechute. Le présent article a pour objectif de résumer certains des plus récents courants en matière de conceptualisation neurobiologique de la toxicomanie de même que les nouvelles pistes de traitement en découlant.For years, the neurobiology of drug addiction was characterized by the short-term modulation of different neurotransmission systems, therapeutic strategies directly targeting the receptors that are bound by substances. These approaches have helped to improve the treatment of drug intoxication and withdrawal, while promoting access to a broad array of psychosocial services. However, the data highlight the mixed effectiveness of these interventions to induce a sustained decrease in consumption and other symptoms of addiction, especially craving, among subgroups of individuals. Recent advances in neuroscience have led to a growing understanding of the neurobiological mechanisms underlying the vulnerability to relapse and other behaviors associated with addiction. The primarily dopaminergic and striatal hypothesis of these phenomena has been replaced by a theory incorporating the contribution of the glutamatergic, endocannabinoid and opioid systems, as well as the interaction between these various components within cortical and sub-cortical structures. The focus has moved from the short-term neurobiological changes to the long-lasting modulation of the structures involved in addiction. This paradigm shift led to the emergence of several therapeutic strategies that aim at reducing the risk of relapse by modulating specific neural circuits whose functions are altered by chronic substance use. The endocannabinoid and glutamate systems, in particular, are promising targets for the treatment of craving and relapse. This article aims to summarize some of the latest trends in the neurobiology of addiction as well as new avenues of treatment.Durante mucho tiempo la toxicomanía estuvo asociada en el plano neurobiológico con la modulación a corto plazo de diferentes sistemas de neurotransmisión. Las estrategias de tratamiento apuntaban, por consiguiente, a los receptores que se vinculan directamente con la sustancia que es el origen del abuso. Estos enfoques contribuyeron a mejorar el alivio de los síntomas de intoxicación y abstinencia, favoreciendo al mismo tiempo el acceso a servicios psicosociales adaptados. Sin embargo, en ciertos grupos de individuos, los datos destacan la eficacia a veces mitigada de estas intervenciones destinadas a disminuir de manera continua el consumo y los síntomas relacionados con la toxicomanía, particularmente el craving. Los recientes progresos de la neurociencia permitieron comprender mejor los mecanismos neurobiológicos que explican la vulnerabilidad ante la recaída. De concepción esencialmente dopaminérgica y estratial, las teorías biológicas de la toxicomanía integran ahora la contribución de los sistemas glutamatérgico, opiáceo y endocanabinoide, así como la interacción entre estos diferentes componentes dentro de las estructuras corticales y subcorticales. El interés parece haberse desplazado de los fenómenos neurobiológicos de corto plazo hacia la modulación prolongada del funcionamiento de las estructuras que están en juego en la toxicomanía. Este cambio de paradigmas condujo al surgimiento de numerosas estratégicas terapéuticas destinadas a disminuir los riesgos de recaída al modular más específicamente los circuitos neuronales cuyo funcionamiento está alterado por el consumo crónico de drogas. Los sistemas endocanabinoide y glutamatérgico, principalmente, aparecen como un objetivo a privilegiar para el tratamiento del craving y la prevención de la recaída. El presente artículo está destinado a resumir algunas de las más recientes corrientes en materia de conceptualización neurobiológica de la toxicomanía y las nuevas vías de tratamiento a las que dichas corrientes dan origen

The rising prevalence of prescription opioid injection and its association with hepatitis C incidence among street-drug users

Ce manuscrit est une pré-publication d'un article paru dans Addiction 2012; 107(7): 1318-1327 url: http://www.addictionjournal.org/IRSC et FRSQ - Réseau SIDA et maladies infectieuse

New testosterone derivatives as semi-synthetic anticancer agents against prostate cancer : synthesis and preliminary biological evaluation

Prostate cancer (PC) is a major health issue in the world. Treatments of localized PC are quite efficient and usually involve surgery, radiotherapy and/or hormonal therapy. Metastatic PC is however rarely curable to this day. Treatments of metastatic PC involve radiotherapy, chemotherapy and hormonal treatment such as orchiectomy, antiandrogens and luteinizing hormone-releasing hormone agonists. The suppression of tumor growth by hormonal treatment is efficient but overtime resistance still occurs and the disease progresses. Thus, more urgently than ever there is a need for discovery of new treatment options for castration-resistant PC (CRPC). Hence, we designed and tested a series of amide derivatives located at position 7α of testosterone as prospective “natural” or “semisynthetic” anticancer agents against CRPC with the goal of discovering therapeutic alternatives for the disease. This manuscript describes an efficient path towards the target molecules that are made in only 6 or 7 chemical steps from testosterone in good overall yields. This strategy can be used to make several compounds of interest that present higher biological activity than the classic antiandrogen; cyproterone acetate (3). The best testosterone-7α-amide was the N-2-pyridylethylamide (25) which was as active as the antiandrogen cyproterone acetate (3) on androgen-dependent LNCaP cells and 2.7 times more active on androgen-independent PC3 prostate cancer cells. The results obtained show the synthetic feasibility and the potential for future development of this unique class of semi-synthetic anticancer agents that offer the premise of new treatment modalities for patients afflicted with CRPC

Visits to primary care physicians among persons who inject drugs at high risk of hepatitis C virus infection: room for improvement

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