Cyclooxygenase-2 inhibitors. 1,5-diarylpyrrol-3-acetic esters with enhanced inhibitory activity toward cyclooxygenase-2 and improved cyclooxygenase-2/cyclooxygenase-1 selectivity.

he important role of cyclooxygenase-2 (COX-2) in the pathogenesis of inflammation and side effect limitations of current COX-2 inhibitor drugs illustrates a need for the design of new compounds based on alternative structural templates. We previously reported a set of substituted 1,5-diarylpyrrole derivatives, along with their inhibitory activity toward COX enzymes. Several compounds proved to be highly selective COX-2 inhibitors and their affinity data were rationalized through docking simulations. In this paper, we describe the synthesis of new 1,5-diarylpyrrole derivatives that were assayed for their in vitro inhibitory effects toward COX isozymes. Among them, the ethyl-2-methyl-5-[4-(methylsulfonyl)phenyl]-1-[3-fluorophenyl]-1H-pyrrol-3- acetate (1d), which was the most potent and COX-2 selective compound, also showed a very interesting in vivo anti-inflammatory and analgesic activity, laying the foundations for developing new lead compounds that could be effective agents in the armamentarium for the management of inflammation and pain

Synthesis, in vitro, and in vivo biological evaluation and molecular docking simulations of chiral alcohol and ether derivatives of the 1,5-diarylpyrrole scaffold as novel anti-inflammatory and analgesic agents.

Following our previous research on anti-inflammatory drugs (NSAIDs), we report here the synthesis of chiral 1,5-diarylpyrroles derivatives that were characterized for their in vitro inhibitory effects toward cyclooxygenase (COX) isozymes. Analysis of enzymatic affinity and COX-2 selectivity led us to the selection of one compound (+/-)-10b that was further tested in vitro in the human whole blood (HWB) and in vivo for its anti-inflammatory activity in mice. The affinity data have been rationalized through docking simulations

Two-photon bidirectional control and imaging of neuronal excitability with cellular resolution in vivo

Two-photon bidirectional control and imaging of neuronal excitability with cellular resolution in viv

Reaction of citrus somatic hybrids to the infection by Phytophthora nicotianae

Este trabalho avaliou a resistência à infecção de tronco e de raízes por Phytophthora nicotianae em híbridos somáticos de citros com potencial para serem utilizados como porta-enxertos. Os híbridos somáticos avaliados foram laranja 'Hamlin' (Citrus sinensis) + toranja 'Indian Red' (Citrus grandis) (plantas 1 e 2) e laranja 'Hamlin' (C. sinensis) + toranja 'Singapura' (C. grandis). Plantas de limão 'Cravo' (Citrus limonia), laranja 'Caipira' (C. sinensis), laranja-azeda (C. aurantium) e Poncirus trifoliata 'Davis A' (Poncirus trifoliata) foram utilizadas como plantas-controle devido à reação conhecida à infecção pelo patógeno. Avaliações realizadas entre 30 e 60 dias após as inoculações com o patógeno incluíram o comprimento das lesões no tronco e a massa seca do sistema radicular nas plantas avaliadas. O híbrido somático laranja 'Hamlin' + toranja 'Indian Red' (planta 1) mostrou-se tolerante a P. nicotianae, indicando potencial para continuidade nas suas avaliações como porta-enxerto para citros.This study aimed to evaluate the resistance to trunk and root infection by Phytophthora nicotianae in citrus somatic hybrids with potential to be utilized as rootstocks. The somatic hybrids evaluated were 'Hamlin' sweet orange (Citrus sinensis) + 'Indian Red' pummelo (Citrus grandis) (plants 1 and 2), and 'Hamlin' sweet orange (C. sinensis) + 'Singapura' pummelo (C. grandis). Plants of 'Rangpur' lime (Citrus limonia), 'Caipira' sweet orange (C. sinensis), sour orange (C. aurantium), and Poncirus trifoliata 'Davis A' (Poncirus trifoliata) were used as control due to their known reaction to the pathogen. Evaluations performed between 30 and 60 days after pathogen inoculation included the length of trunk lesions, and root dry mass of the root system of evaluated plants. The somatic hybrid 'Hamlin' sweet orange + 'Indian Red' pummelo (plant 1) was tolerant to P. nicotianae, indicating potential to be further evaluated as a rootstock.Fundo de Defesa da Citricultura (FUNDECITRUS), pelo apoio financeiro; a primeira autora agradece ao CNPq, pela bolsa de Iniciação Científica; o segundo e terceiro autores agradecem ao CNPq, pela bolsa de produtividade em pesquisa; os autores agradecem ao Pesquisador Eduardo Feichtenberger (Unidade de Pesquisa e Desenvolvimento de Sorocaba, APTA Regional), pelo fornecimento do isolado de Phytophthora nicotianae utilizado no experimento

Identification of a Novel Drug Lead That Inhibits HCV Infection and Cell-to-Cell Transmission by Targeting the HCV E2 Glycoprotein

Hepatitis C Virus (HCV) infects 200 million individuals worldwide. Although several FDA approved drugs targeting the HCV serine protease and polymerase have shown promising results, there is a need for better drugs that are effective in treating a broader range of HCV genotypes and subtypes without being used in combination with interferon and/or ribavirin. Recently, two crystal structures of the core of the HCV E2 protein (E2c) have been determined, providing structural information that can now be used to target the E2 protein and develop drugs that disrupt the early stages of HCV infection by blocking E2’s interaction with different host factors. Using the E2c structure as a template, we have created a structural model of the E2 protein core (residues 421–645) that contains the three amino acid segments that are not present in either structure. Computational docking of a diverse library of 1,715 small molecules to this model led to the identification of a set of 34 ligands predicted to bind near conserved amino acid residues involved in the HCV E2: CD81 interaction. Surface plasmon resonance detection was used to screen the ligand set for binding to recombinant E2 protein, and the best binders were subsequently tested to identify compounds that inhibit the infection of Huh-7 cells by HCV. One compound, 281816, blocked E2 binding to CD81 and inhibited HCV infection in a genotype-independent manner with IC50’s ranging from 2.2 µM to 4.6 µM. 281816 blocked the early and late steps of cell-free HCV entry and also abrogated the cell-to-cell transmission of HCV. Collectively the results obtained with this new structural model of E2c suggest the development of small molecule inhibitors such as 281816 that target E2 and disrupt its interaction with CD81 may provide a new paradigm for HCV treatment

Novel ester and acid derivatives of the 1,5-diarylpyrrole scaffold as anti-inflammatory and analgesic agents. Synthesis and in vitro and in vivo biological evaluation.

A new generation of selective cyclooxygenase-2 (COX-2) inhibitors (coxibs) was developed to circumvent the major side effects of cyclooxygenase-1 (COX-1) and COX-2 inhibitors (stomach ulceration and nephrotoxicity). As a consequence, coxibs are extremely valuable in treating acute and chronic inflammatory conditions. However, the use of coxibs, such as rofecoxib (Vioxx), was discontinued because of the high risk of cardiovascular adverse events. More recent clinical findings highlighted how the cardiovascular toxicity of coxibs could be mitigated by an appropriate COX-1 versus COX-2 selectivity. We previously reported a set of substituted 1,5-diarylpyrrole derivatives, selective for COX-2. Here, we describe the synthesis of new1,5-diarylpyrroles along with their inhibitory effects in vitro, ex vivo, and in vivo toward COX isoenzymes and their analgesic activity. Isopropyl-2-methyl-5-[4- (methylsulfonyl)phenyl]-1-phenyl-1H-pyrrole-3-acetate (10a), a representative member of the series, was selected for pharmacokinetic and metabolic studies

Systematic review of the scientific literature on the economic evaluation of cochlear implants in paediatric patients

The aim of the study consists in a systematic review concerning the economic evaluation of cochlear implant (CI) in children by searching the main international clinical and economic electronic databases. All primary studies published in English from January 2000 to May 2010 were included. The types of studies selected concerned partial economic evaluation, including direct and indirect costs of cochlear implantation; complete economic evaluation, including minimization of costs, cost-effectiveness analysis (CEA), cost-utility analysis (CUA) and cost-benefit analysis (CBA) performed through observational and experimental studies. A total of 68 articles were obtained from the database research. Of these, 54 did not meet the inclusion criteria and were eliminated. After reading the abstracts of the 14 articles selected, 11 were considered eligible. The articles were then read in full text. Furthermore, 5 articles identified by bibliography research were added manually. After reading 16 of the selected articles, 9 were included in the review. With regard to the studies included, countries examined, objectives, study design, methodology, prospect of analysis adopted, temporal horizon, the cost categories analyzed strongly differ from one study to another. Cost analysis, cost-effectiveness analysis and an analysis of educational costs associated with cochlear implants were performed. Regarding the cost analysis, only two articles reported both direct cost and indirect costs. The direct cost ranged between € 39,507 and € 68,235 (2011 values). The studies related to cost-effectiveness analysis were not easily comparable: one study reported a cost per QALY ranging between $5197 and$ 9209; another referred a cost of $2154 for QALY if benefits were not discounted, and$ 16,546 if discounted. Educational costs are significant, and increase with the level of hearing loss and type of school attended. This systematic review shows that the healthcare costs are high, but savings in terms of indirect and quality of life costs are also significant. Cochlear implantation in a paediatric age is cost-effective. The exiguity and heterogeneity of studies did not allow detailed comparative analysis of the studies included in the review

Cavernous Sinus Hemangioma: Diagnosis and Treatment

Cavernous hemangiomas of the maxillary sinus are rare. Here, we describe the management of a rare case of this vascular tumor of the maxillary sinus. We propose that an effective treatment can be achieved by performing endoscopic sinus surgery, preceded by a pre-operative embolization

O direito das Testemunhas de Jeová à recusa às transfusões de sangue

Atualmente há mais de 700 mil Testemunhas de Jeová no Brasil, que se recusam rotundamente a receber em seus corpos sangue ou seus principais componentes. De um lado, apresenta-se o paciente informado, esclarecido, que deseja exercer seu direito à liberdade e à autonomia, por decidir o melhor tratamento para si; do outro lado, a classe médica, que enfrenta várias dificuldades inerentes à profissão, tem de cumprir com os preceitos do Código de Ética Médica e por vezes deseja salvar a vida do paciente a qualquer custo, transfundindo sangue sem sequer recorrer ao Poder Judiciário para obter autorização. O objetivo deste trabalho é demonstrar que, assim como ocorre na maioria dos países desenvolvidos, o paciente tem o direito constitucional de decidir sobre seu próprio corpo. Faz parte dos seus direitos da personalidade dispor sobre sua integridade física e mental. Além disso, busca-se mostrar os riscos da transfusão de sangue como tratamento médico, bem como os bons resultados de tratamentos alternativos simples, seguros e eficazes. Também se enfrenta a polémica questão de pacientes menores, filhos de Testemunhas de Jeová. Por fim, analisa-se a responsabilidade ética, civil e penal do médico diante da recusa à transfusão de sangue pelo doente. Em síntese, o que se quer é mostrar que o direito de escolha é inviolável, não importa quão grave seja o estado de saúde do paciente, nem se ele se encontra em "iminente risco de vida"