Current and Future Prospects of Nitro-compounds as Drugs for Trypanosomiasis and Leishmaniasis

Interest in nitroheterocyclic drugs for the treatment of infectious diseases has undergone a resurgence in recent years. Here we review the current status of monocyclic and bicyclic nitroheterocyclic compounds as existing or potential new treatments for visceral leishmaniasis, Chagas' disease and human African trypanosomiasis. Both monocyclic (nifurtimox, benznidazole and fexinidazole) and bicyclic (pretomanid (PA-824) and delamanid (OPC-67683)) nitro-compounds are prodrugs, requiring enzymatic activation to exert their parasite toxicity. Current understanding of the nitroreductases involved in activation and possible mechanisms by which parasites develop resistance is discussed along with a description of the pharmacokinetic / pharmacodynamic behaviour and chemical structure-activity relationships of drugs and experimental compounds.</p

The growth dynamics in Brachiaria species according to nitrogen dose and shade

It was studied the effects of shading (0, 36 and 54%) and of four nitrogen doses (0, 50, 100 and 150 mg N/dm³ of soil) on the morphogenetic traits and on the tillering of grasses of Brachiaria genus (B. decumbens, B. ruziziensis and B. brizantha cv. Marandu and cv. Xaraes), cultivated in pots with 5 kg substrate. It was used a complete random design, in a 3 × 4 × 4 factorial scheme with three replications. Nitrogen promoted increase in leaf appearance rate and in average leaf blade length, whereas shading increased stem elongation rate. Leaf elongation rate and tillering varied with the interaction among shading percentages and nitrogen doses. Shading increased response efficiency of leaf elongation rate to nitrogen doses, but reduced for tillering, evidencing priority existing tillering growth in detriment to appearance of new tillers when there is light restriction for the plants. Phenotypic adjustments, in response to light reduction, indicate that the studied grasses present tolerance to moderate shading.Estudaram-se os efeitos do sombreamento (0, 36 e 54%) e de doses de nitrogênio (0, 50, 100 e 150 mg/dm³ de solo) nas características morfogênicas e no perfilhamento de gramíneas do gênero Brachiaria (B. decumbens, B. ruziziensis e B. brizantha cvs. Marandu e Xaraes) cultivadas em vasos com capacidade para 5 kg de substrato. Adotou-se o delineamento inteiramente casualizado, em esquema fatorial 3 × 4 × 4 com três repetições. O nitrogênio promoveu aumento na taxa de aparecimento de folhas e no comprimento médio das lâminas foliares, enquanto o sombreamento aumentou a taxa de alongamento do colmo. A taxa de alongamento de folhas e o perfilhamento variaram com a interação entre as percentagens de sombra e as doses de nitrogênio. O sombreamento aumentou a eficiência de resposta da taxa de alongamento de folhas às doses de nitrogênio, mas reduziu para o perfilhamento, evidenciando prioridade no crescimento de perfilhos existentes em detrimento do surgimento de novos perfilhos quando há restrição de luminosidade para as plantas. Os ajustes fenotípicos, em resposta à diminuição de luz, indicam que as forrageiras estudadas apresentam tolerância ao sombreamento moderado

Custo do transplante hepático no Hospital de Clínicas da Universidade Federal do Paraná Cost of liver transplantation at the Clinical Hospital of the Federal University of Parana, Brazil

OBJETIVO. Determinar o custo do transplante hepático no Hospital de Clínicas da Universidade Federal do Paraná. MÉTODO. Os dados do prontuário de 24 pacientes submetidos a 25 transplantes hepáticos foram avaliados do dia da internação para o transplante hepático até a data da alta hospitalar ou óbito para determinar o número de dias de internação, o local de internação, a quantidade de material e medicamentos usados, os exames complementares e procedimentos realizados. Honorários médicos não foram incluídos no estudo. RESULTADOS. A idade dos pacientes variou de 6 a 56 anos, tendo seis deles menos que 14 anos de idade. Cinco pacientes foram a óbito durante a internação hospitalar. Retransplante foi realizado em somente um paciente. O custo médio da retirada do fígado do doador foi de US$2,783.19. O custo total do transplante hepático variou amplamente entre os pacientes, na dependência de ocorrência de complicações pós-operatórias, do número de dias de internação hospitalar e da quantidade de transfusão de hemoderivados. O custo total variou de US$ 6,359.84 a US$75,434.18, com média de US$ 21,505.53. O item mais caro do transplante hepático foi o custo com a hemoterapia, seguido do custo com medicamentos e diária hospitalar. CONCLUSÃO. O custo do transplante hepático varia muito entre os pacientes e pode ser realizado no Brasil a um custo inferior ao relatado nos Estados Unidos e na Europa.<br>PURPOSE - To determine the cost of liver transplantation at the Clinical Hospital of the Federal University of Parana. METHODS - The data of 24 patients subjected to 25 liver transplantations were evaluated from the day of hospital admission until the day of discharge to determine the length of hospitalization, quantity of material and medications used, and exams and procedures performed. Professional fees were not included in the study. RESULTS - The age of the patients varied from 6 to 56 years. Six patients were younger than 14 years of age. Five patients died during hospitalization. Re-transplantation was performed in only one patient. The average cost for liver procurement was US$2,783.19. The total cost of the liver transplantation varied, depending on the occurrence of complications, length of hospitalization and the amount of blood products transfused. The total cost varied from US$ 6,359.84 to US$75,434.18, with an average of US$ 21,505.53. The most expensive item of the liver transplantation was blood products transfused, followed by medications, and intensive care and room charges. CONCLUSION - The cost of liver transplantation varies among the patients and may be performed in Brazil at a cost less than that reported in the United States and Europe