Anti-inflammatory and anti-arthritic activities of 3,4-dihydro-2,2-dimethyl-2H-naphthol[1,2-b]pyran-5,6-dione (ß-lapachone).

OBJECTIVE AND DESIGN: The purpose of this study was to evaluate the anti-inflammatory and anti-arthritic activities of 3,4-dihydro-2,2-dimethyl-2H-naphthol[1,2-b]pyran-5,6-dione (ß-lapachone; ß-lap) and to elucidate its probable mode of action. METHODS: Carrageenan-induced paw edema, cell migration evaluation and production of pro-inflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-6 and nitric oxide were used for this study. Freund's complete adjuvant (FCA)-induced arthritis was used as a model of chronic inflammation. ß-Lap was tested in doses of 40 and 60 mg/kg, orally. RESULTS: In the paw edema test, the dose of 60 mg/kg gave a higher percentage inhibition of edema (49.3 %) than control. ß-Lap inhibited neutrophil migration and reduced concentrations of TNF-α, IL-6 and NO in peritoneal exudates of animals with peritonitis. In the arthritis test, ß-lap inhibited edema and NO production in the serum of treated animals. CONCLUSION: Significant anti-inflammatory and anti-arthritic activities were observed in animals treated with ß-lap. The effects of ß-lap can be attributed in part to immunomodulation with reduction of pro-inflammatory cytokines and NO.

Interventions for wound healing among diabetic patients infected with Staphylococcus aureus: a systematic review.

CONTEXT AND OBJECTIVE: Staphylococcus aureus is the most frequent agent isolated in diabetic foot infections and may be associated with changes to wound healing times. The aim of this study was to perform a systematic review of the literature, including studies that assessed the efficacy of any clinical or surgical intervention, as well as oral or topical therapy for diabetic ulcers infected with S. aureus. DESIGN AND SETTING: Systematic review with a search conducted in databases. METHODS: We conducted a systematic review with a comprehensive search in the Lilacs, SciELO, PubMed/Medline, Old Medline, Embase and Cochrane Library databases, for articles published from 1966 to 2010. The articles selected were limited to studies on diabetic patients with wounds infected with S. aureus for whom their healing was followed up, with the use of either antibiotics or experimental treatments. Animal studies and those that did not report the wound healing, as well as review articles, were excluded. RESULTS: Five studies that met the inclusion and exclusion criteria were analyzed. CONCLUSIONS: There are few studies reporting the healing of wounds infected with S. aureus in diabetic patients, although this is the most commonly found pathogen in this type of wound and it frequently consists of methicillin-resistant S. aureus (MRSA). There is insufficient evidence to support early use of broad-spectrum antibiotics against MRSA to promote healing of diabetic ulcers, since antibiotic resistance may develop from such treatment. This highlights the need for further studies on the subject.

Interventions for wound healing among diabetic patients infected with Staphylococcus aureus: a systematic review / Intervenções para a cicatrização de feridas de pacientes diabéticos infectados com Staphylococcus aureus: uma revisão sistemática

CONTEXT AND OBJECTIVE: Staphylococcus aureus is the most frequent agent isolated in diabetic foot infections and may be associated with changes to wound healing times. The aim of this study was to perform a systematic review of the literature, including studies that assessed the efficacy of any clinical or surgical intervention, as well as oral or topical therapy for diabetic ulcers infected with S. aureus. DESIGN AND SETTING: Systematic review with a search conducted in databases. METHODS: We conducted a systematic review with a comprehensive search in the Lilacs, SciELO, PubMed/Medline, Old Medline, Embase and Cochrane Library databases, for articles published from 1966 to 2010. The articles selected were limited to studies on diabetic patients with wounds infected with S. aureus for whom their healing was followed up, with the use of either antibiotics or experimental treatments. Animal studies and those that did not report the wound healing, as well as review articles, were excluded. RESULTS: Five studies that met the inclusion and exclusion criteria were analyzed. CONCLUSIONS: There are few studies reporting the healing of wounds infected with S. aureus in diabetic patients, although this is the most commonly found pathogen in this type of wound and it frequently consists of methicillin-resistant S. aureus (MRSA). There is insufficient evidence to support early use of broad-spectrum antibiotics against MRSA to promote healing of diabetic ulcers, since antibiotic resistance may develop from such treatment. This highlights the need for further studies on the subject.

CONTEXTO: Staphylococcus aureus é o agente mais frequentemente isolado nas infecções de pé em pacientes diabéticos e pode estar associado a mudança no tempo de cicatrização de feridas. O objetivo deste estudo foi realizar uma revisão sistemática da literatura, incluindo estudos que avaliaram a eficácia de qualquer intervenção clínica, cirúrgica, bem como terapia oral ou tópica para o tratamento de úlceras diabéticas infectadas com o S. aureus. TIPO DE ESTUDO E LOCAL: Revisão sistemática com busca realizada em bancos de dados. MÉTODOS: Realizamos uma revisão sistemática com uma busca abrangente nos bancos de dados Lilacs, SciELO, PubMed/Medline, Old Medline, Embase e no banco de dados da biblioteca Cochrane, publicados entre 1966 e 2010. Os artigos selecionados foram limitados aos estudos com feridas infectadas por S. aureus de pacientes diabéticos, que tiveram cicatrização relatada, quer pela utilização de antibióticos ou por substâncias experimentais. Foram excluídos os estudos com animais e os que não relataram a cicatrização das feridas, bem como artigos de revisão. RESULTADOS: Foram analisados cinco estudos que obedeceram aos critérios de inclusão e exclusão. CONCLUSÕES: Raros estudos relataram cicatrização de feridas infectadas com S. aureus em pacientes diabéticos, embora este seja o patógeno mais comumente encontrado neste tipo de ferida, sendo frequentemente resistente à meticilina MRSA (methicillin-resistant S. aureus). Não há evidências suficientes que suportem a utilização precoce de antibióticos de amplo espectro contra MRSA para promoção da cicatrização de úlceras diabéticas, uma vez que o desenvolvimento de resistência a antibióticos pode decorrer desse tipo de tratamento. Isso evidencia a necessidade de novos estudos sobre o assunto.

Validation of a reversed-phase high-performance liquid chromatography method with fluorescence detection for the bioequivalence study of norfloxacin in plasma samples.

A robust method for the determination of norfloxacin in human plasma, using reversed-phase high-performance liquid chromatography (RP-HPLC) with fluorescence detection, has been developed. The method involves precipitation of plasma protein with acetonitrile and the use of ciprofloxacin as internal standard (IS). Chromatographic separations were performed on a Synergi MAX-RP 150 x 4.6-mm, 4-micro column with an elution system consisting of a mixture of phosphate buffer-acetonitrile (85:15, v/v). The calibration curve was linear, in the range of 30 to 3500 ng/mL. The recoveries at concentrations of 90, 1400, and 2800 ng/mL were 103.5%, 100.2%, and 100.2%, respectively. The quantification limit for norfloxacin was 30 ng/mL per 10-microL injection employing fluorescence detection with excitation and emission set at 300 and 450 nm, respectively. The method validation included examining the within-run and between-run precision and accuracy and ensuring that these were within accepted limits; in summary, the precision was <8.6% and accuracy ranged from 95.8% to 104.1% for concentration from 90 to 2800 ng/mL. The precision and accuracy for the lowest calibration standard (30 ng/mL) was well within accepted limits for lower limit of quantification. The method was then applied in a bioequivalence study in healthy volunteers given 400-mg doses of reference and test formulations of norfloxacin in random order and including a 7-day washout phase.