Testicular Evaluation Using Shear Wave Elastography (SWE) in Patients with Varicocele.

PURPOSE: To assess the possible influence of the presence of varicocele on the quantification of testicular stiffness. METHODS: Ultrasound with shear wave elastography (SWE) was performed on 48 consecutive patients (96 testicles) referred following urology consultation for different reasons. A total of 94 testes were studied and distributed in three groups: testes with varicocele (group A, n = 19), contralateral normal testes (group B; n = 13) and control group (group C, n = 62). Age, testicular volume and testicular parenchymal tissue stiffness values of the three groups were compared using the Kruskal-Wallis test. RESULTS: The mean age of the patients was 42.1 ± 11.1 years. The main reason for consultation was infertility (64.6%). The mean SWE value was 4 ± 0.4 kPa (kilopascal) in group A, 4 ± 0.5 kPa in group B and 4.2 ± 0.7 kPa in group C or control. The testicular volume was 15.8 ± 3.8 mL in group A, 16 ± 4.3 mL in group B and 16.4 ± 5.9 mL in group C. No statistically significant differences were found between the three groups in terms of age, testicular volume and tissue stiffness values. CONCLUSION: Tissue stiffness values were higher in our control group (healthy testicles) than in patients with varicocele.

Current and Advanced Applications of Gadoxetic Acid-enhanced MRI in Hepatobiliary Disorders.

Gadoxetic acid is an MRI contrast agent that has specific applications in the study of hepatobiliary disease. After being distributed in the vascular and extravascular spaces during the dynamic phase, gadoxetic acid is progressively taken up by hepatocytes and excreted to the bile ducts during the hepatobiliary phase. The information derived from the enhancement characteristics during dynamic and hepatobiliary phases is particularly relevant in the detection and characterization of focal liver lesions and in the evaluation of the structure and function of the liver and biliary system. The use of new MRI sequences and advanced imaging techniques (eg, relaxometry, multiparametric imaging, and analysis of heterogeneity), the introduction of artificial intelligence, and the development of biomarkers and radiomic and radiogenomic tools based on gadoxetic acid-enhanced MRI findings will play an important role in the future in assessing liver function, chronic liver disease, and focal liver lesions; in studying biliary pathologic conditions; and in predicting treatment responses and prognosis. © RSNA, 2023 Quiz questions for this article are available in the supplemental material.

Curcumin-Coumarin Hybrid Analogues as Multitarget Agents in Neurodegenerative Disorders.

Neurodegenerative diseases have a complex nature which highlights the need for multitarget ligands to address the complementary pathways involved in these diseases. Over the last decade, many innovative curcumin-based compounds have been designed and synthesized, searching for new derivatives having anti-amyloidogenic, inhibitory of tau formation, as well as anti-neuroinflammation, antioxidative, and AChE inhibitory activities. Regarding our experience studying 3-substituted coumarins with interesting properties for neurodegenerative diseases, our aim was to synthesize a new series of curcumin-coumarin hybrid analogues and evaluate their activity. Most of the 3-(7-phenyl-3,5-dioxohepta-1,6-dien-1-yl)coumarin derivatives 11-18 resulted in moderated inhibitors of hMAO isoforms and AChE and BuChE activity. Some of them are also capable of scavenger the free radical DPPH. Furthermore, compounds 14 and 16 showed neuroprotective activity against H2O2 in SH-SY5Y cell line. Nanoparticles formulation of these derivatives improved this property increasing the neuroprotective activity to the nanomolar range. Results suggest that by modulating the substitution pattern on both coumarin moiety and phenyl ring, ChE and MAO-targeted derivatives or derivatives with activity in cell-based phenotypic assays can be obtained.

Synthesis and in vitro study of nitro- and methoxy-2-phenylbenzofurans as human monoamine oxidase inhibitors.

A new series of 2-phenylbenzofuran derivatives were designed and synthesized to determine relevant structural features for the MAO inhibitory activity and selectivity. Methoxy substituents were introduced in the 2-phenyl ring, whereas the benzofuran moiety was not substituted or substituted at the positions 5 or 7 with a nitro group. Substitution patterns on both the phenyl ring and the benzofuran moiety determine the affinity for MAO-A or MAO-B. The 2-(3-methoxyphenyl)-5-nitrobenzofuran 9 was the most potent MAO-B inhibitor (IC50 = 0.024 µM) identified in this series, whereas 7-nitro-2-phenylbenzofuran 7 was the most potent MAO-A inhibitor (IC50 = 0.168 µM), both acting as reversible inhibitors. The number and position of the methoxyl groups on the 2-phenyl ring, have an important influence on the inhibitory activity. Molecular docking studies confirmed the experimental results and highlighted the importance of key residues in enzyme inhibition.

7-Amidocoumarins as Multitarget Agents against Neurodegenerative Diseases: Substitution Pattern Modulation.

This study explores the potential of 7-amidocoumarins as multitarget agents against Parkinson's and Alzheimer's diseases, by modulating the substitution patterns within the scaffold. Sixteen compounds were synthesized via 7-amino-4-methylcoumarin acylation, and in vitro evaluation of the molecules against hMAO-A, hMAO-B, hAChE, hBuChE and hBACE1 was performed. Five compounds turned out to be potent and selective hMAO-B inhibitors in the nanomolar range, six displayed inhibitory activity of hMAO-A in the low micromolar range, one showed hAChE inhibitory activity and another one hBACE1 inhibitory activity. MAO-B reversibility profile of 7-(4'-chlorobenzamido)-4-methylcoumarin (10) was investigated, with this compound being a reversible inhibitor. Neurotoxicity on motor cortex neurons and neuroprotection against H2 O2 were also studied, corroborating the safety profile of these molecules. Finally, theoretical ADME properties were also calculated, showing these molecules as good candidates for the optimization of a lead compound. Results suggest that by modulating the substitution pattern at position 7 of the scaffold, selective or multitarget molecules can be achieved.

Vaginal residence and pharmacokinetic preclinical study of topical vaginal mucoadhesive W/S emulsions containing ciprofloxacin.

The aim of this work is to test the in vivo behavior of a mucoadhesive vaginal emulsion resistant to the clearance of vaginal fluids using ciprofloxacin (CPX) as an anti-infective model of drug. CPX is a broad-spectrum antibiotic used in the treatment of sexual tissues infections, as intravenous injection in a dose of 20 mg every 12 h. In this study, CPX was incorporated in water in silicone (W/S) mucoadhesive emulsions and the in vivo residence time and the CPX in vivo absorption and distribution to the sexual organs was studied using the rat as animal model. W/S emulsion shows excellent in vitro bioadhesion having high resistance to the vaginal fluids clearance. The drug release profiles show a constant release of CPX during at least 6 h according to a zero-order kinetics. In vivo computerized PET/CT Image Analysis after intravaginal administration to rats indicates that W/S emulsions remain in the vaginal area for a long time and shows a good absorption of the radiotracers used as markers through the vaginal mucosa. Ciprofloxacin pharmacokinetic studies developed after the single intravaginal administration of W/S emulsion shows a good absorption and distribution of CPX on the uterus and ovarian tissue. A significant concentration of CPX in the sexual tissues was observed after 24 h of administration of W/S emulsion. Therefore, W/S emulsions have a good in vivo residence and drug release in the vaginal mucosae showing a great potential for the treatment of sexual tissues infections, as vaginal bioadhesive delivery systems of antinfectious drugs.

Reacciones adversas a los antimicrobianos en pacientes de Las Tunas / Adverse reactions to antimicrobials in patients from Las Tunas

Fundamento: las consecuencias generadas por el uso masivo e injustificado de antimicrobianos representan en la actualidad serios problemas en el contexto de la salud pública a escala mundial. Objetivo: caracterizar las reacciones adversas producidas por antimicrobianos, notificadas a la base de datos de farmacovigilancia en la provincia Las Tunas, en el período enero-junio de 2017. Métodos: se desarrolló un estudio de farmacovigilancia, observacional, descriptivo y transversal en el lugar y período antes señalados, el universo de estudio estuvo conformado por 460 notificaciones de reacciones adversas y la muestra por los 111 reportes correspondientes a los antimicrobianos. Se aplicaron técnicas de estadística descriptiva para análisis de la información. Las medidas de resumen fueron frecuencia absoluta y porciento. Resultados: el reporte de reacciones adversas a antimicrobianos se mantuvo similar en la mayoría de los meses estudiados, predominaron los reportes de reacciones adversas a antimicrobianos en pacientes del sexo femenino, 61,2 por ciento, en el grupo de edad 19-59 años, 42,3 por ciento. El sistema de órgano más afectado fue la piel en el 33,3 por ciento, seguido del general en el 26,2 por ciento. Predominaron las reacciones adversas leves en el 58,5 por ciento, las probables en el 88,2 por ciento y las frecuentes en el 58,5 por ciento. La mayoría de las reacciones fueron reportadas por médicos, 67,5 por ciento. De acuerdo a los grupos farmacológicos, las cefalosporinas y penicilinas obtuvieron mayores reportes (30,6 y 28,8 por ciento, respectivamente). Conclusiones: se caracterizaron las reacciones adversas producidas por antimicrobianos en pacientes de Las Tunas, en el primer semestre de 2017(AU)

Background: the consequences generated by the massive and unjustified use of antimicrobials currently represent serious problems in the context of public health on a worldwide scale. Objective: to describe the adverse reactions produced by antimicrobials, reported to the pharmacovigilance database in the province of Las Tunas, from January to June 2017. Methods: a pharmacovigilance, observational, descriptive and cross-sectional study was carried out at the aforementioned place and during the period herein declared. The study universe consisted of 460 reports of adverse reactions and the sample was made up of the 111 reports corresponding to antimicrobials. Descriptive statistics techniques were applied to analyze the information. The measures of summary statistics were absolute frequency and percentile. Results: the report of adverse reactions to antimicrobials remained similar in most of the studied months, reports of adverse reactions to antimicrobials in female patients predominated for 61,2 percent, in the 19 to 59 agegroup, 42,3 percent. The most affected organ system was the skin in 33,3 percent, followed by the general system in 26,2 percent. Mild adverse reactions predominated in 58,5 percent, probable adverse reactions in 88,2 percent and frequent adverse reactions in 58,5 percent. The majority of the reactions were reported by physicians, 67,5 percent. According to the drug class, cephalosporins and penicillins had higher reports (30,6 and 28,8 percent, respectively). Conclusions: the adverse reactions produced by antimicrobial agents in patients from Las Tunas were described, in the first semester of 2017(AU)

Caracterización de reacciones adversas notificadas en la base de datos de farmacovigilancia de la provincia Las Tunas / Description of adverse reactions reported in the pharmacovigilance database of province of Las Tunas

Fundamento: los efectos adversos a medicamentos constituyen un problema de salud a nivel mundial y aumentan de manera considerable los costos de la atención hospitalaria. Objetivo: caracterizar las reacciones adversas, notificadas a la base de datos de farmacovigilancia en la provincia Las Tunas, en el período enero-junio 2017. Métodos: se desarrolló un estudio de farmacovigilancia, observacional, descriptivo y transversal en el lugar y período antes señalados, la muestra quedó constituida por 460 notificaciones de reacciones adversas. Se aplicaron técnicas de estadística descriptiva para el análisis de la información. Resultados: predominaron los reportes de reacciones adversas en pacientes del sexo femenino, 61 por ciento y en edad pediátrica, 54 por ciento. El sistema de órgano más afectado fue el general en el 37 por ciento, seguido de la piel, 22 por ciento. La fiebre estuvo presente en el 75,2 por ciento de las notificaciones; predominaron las reacciones adversas leves en el 73,2 por ciento y las probables en el 89,5 por ciento; reportadas por licenciados en enfermería (47 por ciento) y médicos (43 por ciento). Por grupos farmacológicos las mayores incidencias fueron de las vacunas, donde la pentavalente tuvo un 54,7 por ciento; entre los antimicrobianos los betalactámicos aportaron el 60 por ciento de los casos; los inhibidores de la enzima convertidora de angiotensina fueron notificados en el 60,6 por ciento. La acupuntura provocó el 68,7 por ciento de las reacciones adversas ocasionadas por técnicas de la medicina natural y los analgésicos no opioides notificaron 31 reacciones. Conclusiones: se caracterizaron las reacciones adversas notificadas en la base de datos de farmacovigilancia. Resalta el reporte de reacciones adversas notificadas por la aplicación de la acupuntura(AU)

Background: adverse drug effects are a health problem on a worldwide scale and increase the costs of hospital care considerably. Objective: to describe the adverse drug reactions reported to the pharmacovigilance database of the province of Las Tunas, from January to June 2017. Methods: a pharmacovigilance, observational, descriptive and cross-sectional study was carried out at the aforementioned place and during the period herein declared. The sample consisted of 460 reports of adverse reactions. Descriptive statistics techniques were applied for the analysis of the information. Results: reports of adverse reactions were predominant in female patients, 61 percent, and in pediatric age, 54 percent. The organ system mostly affected was the general one in 37 percent, followed by the skin, 22 percent. Fever was present in 75,2 percent of the reports; slight adverse reactions predominated in 73,2 percent and probable reactions in 89,5 percent; reported by nurses (47 percent) and physicians (43 percent). By drug class the highest incidences were from vaccines, where the pentavalent vaccine had 54,7 percent; among the antimicrobials, beta-lactams contributed 60 percent of the cases; angiotensin-converting enzyme inhibitors were reported in 60,6 percent. Acupuncture caused 68,7 percent of the adverse reactions brought on by natural medicine techniques and non-opioid analgesics reported 31 reactions. Conclusions: the adverse reactions reported in the pharmacovigilance database were described. The notification of adverse reactions reported by the application of acupuncture stands out(AU)

3-Amidocoumarins as Potential Multifunctional Agents against Neurodegenerative Diseases.

Monoamine oxidase (MAO) generates reactive oxygen species (ROS), which cause neuronal cell death, causing neurodegeneration. Agents that are able to concurrently inhibit MAO and scavenge free radicals represent promising multifunctional neuroprotective agents that could be used to delay or slow the progression of neurodegenerative diseases. In this work, variously substituted 3-amidocoumarins are described that exert neuroprotection in vitro against hydrogen peroxide in rat cortical neurons, as well as antioxidant activity in a 1,1-diphenyl-2-picrylhydrazyl (DPPH⋅) radical scavenging assay. Selective and reversible inhibitors of the MAO-B isoform were identified. Interestingly, in the case of the 3-benzamidocoumarins, substitution at position 4 with a hydroxy group abolishes MAO-B activity, but the compounds remain active in the neuroprotection model. Further evaluation of 3-heteroarylamide derivatives indicates that it is the nature of the heterocycle that determines the neuroprotective effects. Evaluation in a parallel artificial membrane permeability assay (PAMPA) highlighted the need to further improve the blood-brain barrier permeability of this compound class. However, the compounds described herein adhere to Lipinski's rule of five, suggesting that this novel scaffold has desirable properties for the development of potential drug candidates.

Bioadhesive emulsions for control release of progesterone resistant to vaginal fluids clearance.

The aim of this study is to propose that mucoadhesive vaginal emulsions can be able to resist the clearance effect of vaginal fluid and to have an effective control release of progesterone. With this goal, silicon derivative, cyclomethicone pentamer, was selected as the bioadhesive and water resistant material. In order to obtain a system which is insensitive to the dilution of aqueous fluids, water in silicone (W/S) emulsions were prepared and different proportions of cyclomethicone as well as 8% or 15% w/w of progesterone were employed. The rheological, mechanical and mucoadhesive properties of emulsions were characterized and the drug release was measured for each formulation. Mucoadhesive behavior was determined and the influence of simulated vaginal fluid (SVF) at bioadhesion was assessed using three commercial mucoadhesive vaginal gels (Crinone(®), K-Y jelly(®) and Zidoval(®)) as the bioadhesive references. All assayed emulsions have good rheological and mechanical properties and their consistence and viscosity increase when the proportion of the internal phase increases. Related to mucoadhesion, in the absence of SVF, W/S emulsions showed similar bioadhesive levels like the commercial formulations. However, in the presence of SVF, W/S emulsions are able to keep their mucoadhesive properties while the marketed references drastically lose their consistency and adherence to the vaginal mucosa. Drug release profiles from W/S emulsion show that progesterone is released with pseudo-order zero kinetics and a constant release rate is maintained for at least two weeks. The results of the in vivo studies developed in rats show that after a single vaginal administration, bioadhesive W/S emulsions increase the uterine tissue progesterone levels in young and postmenopausal rats. Moreover in postmenopausal rats, they provide high uterine levels of progesterone compared to the bioadhesive-marketed gel used as a reference. Therefore, W/S emulsions have an interesting potential as bioadhesive vaginal delivery systems for drug administration.

History and therapeutic use of MAO-A inhibitors: a historical perspective of mao-a inhibitors as antidepressant drug.

Since the first generation of MAO inhibitors was developed, more than fifty years ago, this family of drugs has been ups and downs over the last decades. Actually, interest in MAO inhibitors is reviving and the emergence of new advances in the rational design of molecules and new techniques to predict the in vivo behavior has encouraged the research for new drugs with therapeutic potential in this area. The classic MAOIs have been widely used as antidepressants during the two decades after its introduction in clinic. Based on observations made on MAO inhibition by these drugs, it has been postulated hypothesis that have contributed to a better understanding of the mechanism and management of depressive disorders. However, exaggerated concerns about food and drug interactions relegated these drugs from the pharmaceutical landscape. The correct interpretation and the contextualization of side effects and the recent research findings, in which MAO selective inhibitors appear as promising agents in the treatment of emerging and high prevalence diseases, are placing these drugs again into the scientific and pharmacological focus.

8-Substituted 3-arylcoumarins as potent and selective MAO-B inhibitors: synthesis, pharmacological evaluation, and docking studies.

Neurodegenerative disorders are becoming more prevalent given the increase in the aging population. This has inspired active research in the development of new drugs that could mark an important advance in the treatment of complex diseases such as Alzheimer's and Parkinson's. With the aim of finding new MAO-B-selective inhibitors, we report the synthesis, in vitro evaluation, and docking simulation of a new series of 3-arylcoumarins variously substituted at the 8-position. Most of the studied compounds show high affinity and selectivity for the hMAO-B isoform, with IC50 values in the low micro- to nanomolar range. Some of them have greater hMAO-B inhibitory activity and selectivity than the reference compound, selegiline. Compounds 7 and 8 are the most active of this series, with compound 8 being fivefold more potent against MAO-B and severalfold more selective than selegiline. Docking experiments were carried out with hMAO-B crystal structures, providing new information about the enzyme-inhibitor interaction and the potential therapeutic application of the new 8-substituted 3-arylcoumarins.

New pyridazinone derivatives with vasorelaxant and platelet antiaggregatory activities.

New 6-substituted and 2,6-disubstituted pyridazinone derivatives were obtained starting from easily accessible alkyl furans by using oxidation with singlet oxygen to give 4-methoxy or 4-hydroxybutenolides, key intermediates of this synthetic strategy. The new pyridazinone derivatives have been studied as vasorelaxant and antiplatelet agents. Analysis of biological data revealed the silyl ethers (4a-i) and N,O-dibenzyl derivatives (6g-i) as the most active compounds.

2-Substituted 4-, 5-, and 6-[(1E)-3-oxo-3-phenylprop-1-en-1-yl]pyridazin-3(2H)-ones and 2-substituted 4,5-bis[(1E)-3-oxo-3-phenylprop-1-en-1-yl]pyridazin-3(2H)-ones as potent platelet aggregation inhibitors: design, synthesis, and SAR studies.

A set of regioisomeric 2-substituted pyridazin-3(2H)-ones containing a 3-oxo-3-phenylprop-1-en-1-yl fragment at either position 4, 5 or 6 and 2-substituted pyridazin-3(2H)-ones containing the same fragment both at positions 4 and 5 have been synthesized and evaluated as antiplatelet agents. The study allows the identification of a new highly potent platelet aggregation inhibitor (4c).

Design, synthesis, and structure-activity relationships of a novel series of 5-alkylidenepyridazin-3(2H)-ones with a non-cAMP-based antiplatelet activity.

5-alkylidenepyridazin-3-ones with four points of diversity (R2, R6, X, Y) have been synthesized and evaluated as platelet aggregation inhibitors. Several derivatives eliciting antiplatelet activity in the low micromolar range (e.g., 14e, 14k, 14p, 14v, IC50 congruent with 1 microM) were identified. Structure-activity relationships studies on these compounds revealed the key molecular determinants of this new family of antiplatelet agents: (a) two ester groups in the alkoxy moieties; (b) lipophilic substituents at the N2 position of the pyridazin-3-one. The preliminary results of a pharmacological study aimed at determining the mechanism of action of a set of representative compounds revealed that, unlike other pyridazinones, the documented antiplatelet effect is not a consequence of a PDE-III inhibitory activity.

Pyridazines part 41: synthesis, antiplatelet activity and SAR of 2,4,6-substituted 5-(3-oxo-3-phenylprop-1-en-1-yl)- or 5-(3-phenylprop-2-enoyl)pyridazin-3(2H)-ones.

As part of the optimization process of the lead compound I a focussed library of diversely substituted pyridazin-3(2H)-ones containing a 3-oxo-3-phenylprop-1-en-1-yl or 3-phenylprop-2-enoyl fragment at position 5 has been obtained and evaluated as antiplatelet agents. The structural modification at positions 2, 6 and 4 of the heterocyclic moiety allowed us to obtain preliminary information on the structure-activity relationship in this family.

Effects of cis-resveratrol on inflammatory murine macrophages: antioxidant activity and down-regulation of inflammatory genes.

This study investigated for the first time the effects of the cis isomer of resveratrol (c-RESV) on the responses of inflammatory murine peritoneal macrophages, namely on the production of reactive oxygen species (ROS) and reactive nitrogen species (RNS) during the respiratory burst; on the biosynthesis of other mediators of inflammation such prostaglandins; and on the expression of inflammatory genes such as inducible nitric oxide synthase (NOS)-2 and inducible cyclooxygenase (COX)-2. Treatment with 1-100 microM c-RESV significantly inhibited intracellular and extracellular ROS production, and c-RESV at 10-100 microM significantly reduced RNS production. c-RESV at 1-100 microM was ineffective for scavenging superoxide radicals (O(2)(.-)), generated enzymatically by a hypoxanthine (HX)/xanthine oxidase (XO) system and/or for inhibiting XO activity. However, c-RESV at 10-100 microM decreased nicotinamide adenine dinucleotide/nicotinamide adenine dinucleotide phosphate (NADH/NADPH) oxidase activity in macrophage homogenates. c-RESV at 100 microM decreased NOS-2 and COX-2 mRNA levels in lipopolysaccharide (LPS) interferon gamma (IFN-gamma)-treated macrophages. At 10-100 microM, c-RESV also significantly inhibited NOS-2 and COX-2 protein synthesis and decreased prostaglandin E(2) (PGE(2)) production. These results indicate that c-RESV at micromolar concentrations significantly attenuates several components of the macrophage response to proinflammatory stimuli (notably, production of O(2)(.-)(-) and of the proinflammatory mediators NO(.-) and PGE(2)).

Pyridazines. Part 36: Synthesis and antiplatelet activity of 5-substituted-6-phenyl-3(2H)-pyridazinones.

A convenient and efficient palladium-catalysed retro-ene-assisted method has been developed to prepare a series of 5-substituted-6-phenyl-3(2H)-pyridazinones as potential antiplatelet drugs. The most active compounds were those that contain a 3-phenyl-3-oxo-propenyl fragment or a phenylthio group at position 5 of the heterocyclic ring.

Pyridazines. Part 31: synthesis and antiplatelet activity of 4,5-disubstituted-6-phenyl-3(2H)-pyridazinones.

This paper describes the synthesis and the antiplatelet activity of a series of 4,5-disubstituted-6-phenyl-3(2H)-pyridazinones. Some of these compounds show a dose-dependent activity and were found to be more active than their 5-substituted analogues.

Pyridazines. Part XXIX: synthesis and platelet aggregation inhibition activity of 5-substituted-6-phenyl-3(2H)-pyridazinones. Novel aspects of their biological actions.

A series of 6-phenyl-3(2H)-pyridazinones with a diverse range of substituents in the 5-position have been prepared and evaluated in the search for new antiplatelet agents. A significant dependence of the substituent on the inhibitory effect has been observed. The pharmacological study of these compounds confirms that modification of the chemical group at position 5 of the 6-phenyl-3(2H)-pyridazinone system influences both variations in the antiplatelet activity and the mechanism of action.