Preventing medical adhesive-related skin injury (MARSI).

Medical adhesive-related skin injury (MARSI) is an overlooked and underestimated problem. While awareness of this issue is growing, it is not fully understood by health professionals in a variety of clinical settings. Medical adhesive products are often applied and removed incorrectly, which, albeit unintentionally, causes skin damage. In many cases, MARSI should be considered a preventable injury. Organisations should have processes in place to educate health professionals in acute and community facilities in preventing MARSI; these processes should include the use of products that help to prevent these injuries, including medical adhesive removers. This article will explore this topic and relate it to the most recent consensus document.

Cadherin-11 in poor prognosis malignancies and rheumatoid arthritis: common target, common therapies.

Cadherin-11 (CDH11), associated with epithelial to mesenchymal transformation in development, poor prognosis malignancies and cancer stem cells, is also a major therapeutic target in rheumatoid arthritis (RA). CDH11 expressing basal-like breast carcinomas and other CDH11 expressing malignancies exhibit poor prognosis. We show that CDH11 is increased early in breast cancer and ductal carcinoma in-situ. CDH11 knockdown and antibodies effective in RA slowed the growth of basal-like breast tumors and decreased proliferation and colony formation of breast, glioblastoma and prostate cancer cells. The repurposed arthritis drug celecoxib, which binds to CDH11, and other small molecules designed to bind CDH11 without inhibiting COX-2 preferentially affect the growth of CDH11 positive cancer cells in vitro and in animals. These data suggest that CDH11 is important for malignant progression, and is a therapeutic target in arthritis and cancer with the potential for rapid clinical translation.

Discovery of a potent boronic acid derived inhibitor of the HCV RNA-dependent RNA polymerase.

A boronic acid moiety was found to be a critical pharmacophore for enhanced in vitro potency against wild-type hepatitis C replicons and known clinical polymorphic and resistant HCV mutant replicons. The synthesis, optimization, and structure-activity relationships associated with inhibition of HCV replication in a subgenomic replication system for a series of non-nucleoside boron-containing HCV RNA-dependent RNA polymerase (NS5B) inhibitors are described. A summary of the discovery of 3 (GSK5852), a molecule which entered clinical trials in subjects infected with HCV in 2011, is included.

Rapid synthesis and zebrafish evaluation of a phenanthridine-based small molecule library.

A Heck cyclisation approach is described for the rapid synthesis of a library of natural product-like small molecules, based on the phenanthridine core. The synthesis of a range of substituted benzylamine building blocks and their incorporation into the library is reported, together with a highly selective cis-dihydroxylation protocol that enables access to the target compounds in an efficient manner. Biological evaluation of the library using zebrafish phenotyping has led to the discovery of compound 20c, a novel inhibitor of early-stage zebrafish embryo development.

Relationship between the microscopic and macroscopic world in optical oxygen sensing: a luminescence lifetime microscopy study.

An investigation based on confocal fluorescence lifetime imaging microscopy (FLIM) of silica-loaded silicone films doped with a molecular oxygen-sensitive ruthenium(II) polyazaheterocyclic complex is presented. The effect of the silica type (hydrophilic/hydrophobic), particle size and amount of silica filler on the luminescence decay of the immobilized indicator dye has thoroughly been studied. A higher amount of hydrophilic silica leads to both a higher solubility of molecular oxygen into the silicone film and to higher levels of the metal indicator dye. Thus, incorporation of 10% (by wt) pyrogenic silica into silicone shortens the mean luminescence lifetime from 1.4 to 0.9 micros. However, an excess of filler may lead to overloading of the dye into the film producing new phenomena such as triplet-triplet annihilation and excitation energy homotransfer, as observed from their influence on the emission lifetime of the metal complex. Those phenomena do not take place when trimethylated silica (hydrophobic filler) is used. In this case, no increase on the oxygen or dye concentration is observed after addition of the filler and no significant reduction of the luminescence lifetime is measured. Both the addition of silica and the possible precipitation of dye crystals lead to the appearance of microdomains where the molecular probe exhibits widely different excited state lifetimes. For the first time, such microdomains within the oxygen sensing layer are visualized and analyzed by means of FLIM, showing the potential of this technique and the usefulness of our conclusions to the future design and development of novel luminescent oxygen sensor films for environmental and process analysis.

Asymmetric synthesis of an N-acylpyrrolidine for inhibition of HCV polymerase.

A practical asymmetric synthesis of a highly substituted N-acylpyrrolidine on multi-kilogram scale is described. The key step in the construction of the three stereocenters is a [3+2] cycloaddition of methyl acrylate and an imino ester prepared from l-leucine t-butyl ester hydrochloride and 2-thiazolecarboxaldehyde. The cycloaddition features novel asymmetric catalysis via a complex of silver acetate and a cinchona alkaloid, particularly hydroquinine, with complete diastereomeric control and up to 87% enantiomeric control. The alkaloid serves as a ligand as well as a base for the formation of the azomethine ylide or 1,3-dipole. Experiments have shown that the hydroxyl group of hydroquinine is a critical element for the enantioselectivities observed. The cycloaddition methodology is also applicable to methylvinyl ketone, providing access to either alpha- or beta-epimers of 4-acetylpyrrolidine depending on the reaction conditions utilized. The synthesis also highlights an efficient N-acylation, selective O- versus N-methylation, and a unique ester reduction with NaBH4-MeOH catalyzed by NaB(OAc)3H that not only achieves excellent chemoselectivity but also avoids formation of the undesired but thermodynamically favored epimer. The highly functionalized target is synthesized in seven linear steps from l-leucine t-butyl ester hydrochloride with all three isolated intermediates being highly crystalline.

Studies on acyl pyrrolidine inhibitors of HCV RNA-dependent RNA polymerase to identify a molecule with replicon antiviral activity.

The SAR development is described for a series of N-acyl pyrrolidine inhibitors of the Hepatitis C virus RNA-dependent RNA polymerase, NS5B, from tractable Delta21 enzyme inhibitors to an example with antiviral activity in a cellular assay (HCV replicon).

Optimization of novel acyl pyrrolidine inhibitors of hepatitis C virus RNA-dependent RNA polymerase leading to a development candidate.

Optimization of a pyrrolidine-based template using structure-based design and physicochemical considerations has provided a development candidate 20b (3082) with submicromolar potency in the HCV replicon and good pharmacokinetic properties.

Discovery of substituted maleimides as liver X receptor agonists and determination of a ligand-bound crystal structure.

Substituted 3-(phenylamino)-1H-pyrrole-2,5-diones were identified from a high throughput screen as inducers of human ATP binding cassette transporter A1 expression. Mechanism of action studies led to the identification of GSK3987 as an LXR ligand. GSK3987 recruits the steroid receptor coactivator-1 to human LXRalpha and LXRbeta with EC(50)s of 40 nM, profiles as an LXR agonist in functional assays, and activates LXR though a mechanism that is similar to first generation LXR agonists.

5-aryl-pyrazolo[3,4-b]pyridazines: potent inhibitors of glycogen synthase kinase-3 (GSK-3).

Introduction of a nitrogen atom into the 6-position of a series of pyrazolo[3,4-b]pyridines led to a dramatic improvement in the potency of GSK-3 inhibition. Rationalisation of the binding mode suggested participation of a putative structural water molecule, which was subsequently confirmed by X-ray crystallography.

The effect of parental expressed emotion on glycaemic control in children with Type 1 diabetes. Parental expressed emotion and glycaemic control in children.

OBJECTIVE: To measure expressed emotion (EE) in parents of young children with diabetes and to examine the relation between EE and glycaemic control in children with Type 1 diabetes in a longitudinal study over 24 months. We hypothesised that good glycaemic control, as measured by low glycated haemoglobin levels, would be predicted by high parental emotional over-involvement, low frequency of critical comments and absence of hostility. We predicted that these effects would be stronger in maternal than paternal scores. METHODS: Forty-seven children attending a Paediatric Diabetes Clinic and their parents were studied over 24 months. Glycated haemoglobin was measured on three occasions, at the start of the study period, 12 and 24 months later. At 12 months, parental EE was measured using an adapted version of the Camberwell Family Interview, and child emotional and behavioural problems were measured using the parent version of the Child Behavior Checklist. Multiple regression models were used to test the hypotheses. RESULTS: Forty-three maternal and 33 paternal interviews of adequate quality for analysis were obtained. Paternal hostility was found to be associated with elevated glycated haemoglobin measured 12 months before interview and 12 months after interview, accounting for 22% and 29% of the variation in glycated haemoglobin respectively. CONCLUSIONS: We did not find that parental emotional over-involvement or criticism predicted glycaemic control. Presence of hostility was important, but in contrast to our hypothesis, this was paternal rather than maternal hostility. We suggest that (i) relatively absent, rejecting fathers play little role in diabetes management and children perceive this negatively, or (ii) mothers who are unsupported by fathers cannot in turn support their children in diabetes care.