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1.
Chemistry ; 26(26): 5765-5769, 2020 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-32048370

RESUMO

Tertiary phosphines are generally known to withstand inversion under moderate conditions. In this work, a remarkable racemization process of three P-chiral ferrocenyl phosphines is reported. Subjected to conventional column chromatography as highly enantioenriched compounds, they greatly experienced racemization when collected at the column outlet within minutes. Initially, attention was drawn to this unusual inversion behavior after observing that the superb enantiomeric excess of these ligands (>95 % ee in all cases) was almost lost in their corresponding ruthenium(II) complexes. Successively excluding possible racemization causes, these P-chiral ferrocenyl phosphines were found to undergo a significant, acid-catalyzed racemization process at room temperature within a few minutes. This process is mainly observed during standard column chromatography by using conventional silica or alumina, but can also be triggered deliberately by addition of certain acids. Therefore, the stereochemical preservation of P-chiral phosphines during their purification may per se not always be guaranteed, since column chromatography is the most frequently used technique for purifying such types of compounds.

2.
ChemMedChem ; 14(24): 2061-2074, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31675152

RESUMO

The role of autophagy in cancer is often complex, ranging from tumor-promoting to -suppressing effects. In this study, two novel hybrid molecules were designed, containing a ruthenacarborane fragment conjugated with a known modulator of autophagy, namely a quinoline derivative. The complex closo-[3-(η6 -p-cymene)-1-(quinolin-8-yl-acetate)-3,1,2-RuC2 B9 H10 ] (4) showed a dual mode of action against the LN229 (human glioblastoma) cell line, where it inhibited tumor-promoting autophagy, and strongly inhibited cell proliferation, de facto blocking cellular division. These results, together with the tendency to spontaneously form nanoparticles in aqueous solution, make complex 4 a very promising drug candidate for further studies in vivo, for the treatment of autophagy-prone glioblastomas.

3.
Inflamm Bowel Dis ; 24(3): 490-501, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-29462395

RESUMO

Background: The purpose of this study was to compare the long-term safety of infliximab and nonbiologic agents as Crohn's disease (CD) therapy. Methods: Patients with CD were prospectively evaluated in this large, observational registry. Results: Patients (n = 6273) participated in this observational registry from July 1999 through March 2012; 3440 (54.8%) received infliximab (20,971 patient-years), and 2833 (45.2%) received other treatments only (14,806 patient-years). Overall, 59,875 infliximab infusions were administered (80%, 5 mg/kg); 3006 (89.9%) patients received ≥2 infusions. Adverse events (AEs), most commonly those related to CD (eg, abdominal pain, diarrhea), and serious AEs occurred at a higher rate among infliximab-treated patients. Mortality (0.57/100 patient-years, 0.67/100 patient-years) and malignancy rates (0.69/100 patient-years, 0.71/100 patient-years) for infliximab-treated and other-treatments-only patients, respectively, were generally similar. Serious infection rates were higher for infliximab-treated (2.15/100 patient-years) than other-treatments-only patients (0.86/100 patient-years). Infliximab dose was not associated with mortality or serious infection. An increased risk of serious infection was observed with age (>52 years vs ≤30 years) when examined in infliximab-treated patients. Nonserious cerebrovascular accidents (13 events, 0.06/100 patient-years; 5 events, 0.03/100 patient-years) and pulmonary embolisms (11 events, 0.05/100 patient-years; 4 events 0.03/100 patient-years) also occurred at higher rates among infliximab-treated patients than other-treatments-only patients. Conclusions: Through more than 13 years of registry experience and an overall median duration of patient follow-up >6 years, mortality was similar between the infliximab-treated and other-treatments-only groups. These final cumulative results are representative of real-world experience among infliximab-treated patients with CD and are consistent with the known risks of disease activity and tumor necrosis factor antagonist therapy.


Assuntos
Doença de Crohn/tratamento farmacológico , Doença de Crohn/mortalidade , Imunossupressores/uso terapêutico , Infliximab/uso terapêutico , Adulto , Feminino , Humanos , Imunossupressores/efeitos adversos , Infliximab/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Análise de Regressão , Resultado do Tratamento , Estados Unidos/epidemiologia
4.
AAPS J ; 19(1): 161-171, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27600137

RESUMO

Monitoring infliximab (IFX) concentrations and antibodies-to-IFX (ATI) titers during inflammatory bowel disease treatment may allow more informed decisions in assessing exposure/response and determining appropriate dosing. To aid in interpreting results from different commercial tests in the context of Janssen's published Remicade® results, the reliability of Janssen's IFX and ATI assays was compared with commercial assays from KU Leuven, Sanquin, Dynacare, and LabCorp. Test results were independently reported to Janssen. All assays were tested for specificity, selectivity, and precision. ATI assays were evaluated for sensitivity, drug interference, and potential interference of tumor necrosis factor-alpha (TNF-α). IFX assays were specific, accurate, and reproducible. Intra-class correlation of Janssen IFX assay results with those from KU Leuven, Sanquin, Dynacare, and LabCorp were 0.960, 0.895, 0.931, and 0.971, respectively. ATI titers >10 interfered with IFX assessment in all IFX assays, whereas TNF-α (≤50 ng/mL) did not interfere with IFX detection in any assay. ATI assays specifically and reproducibly detected ATI. Janssen, Sanquin, and LabCorp ATI methods were more resistant to IFX interference than Dynacare and KU Leuven, which were affected by IFX concentrations at ≥2 µg/mL. TNF-α (<5 ng/mL) did not interfere with ATI detection. Strong agreement was observed between Janssen's IFX and ATI assays and the diagnostic service provider assays. Our study results indicate that all four commercially available assays are suitable for therapeutic drug monitoring of IFX. The substantial agreement reported here between the comparator assays and the Janssen drug-tolerant assay provides support to clinicians in their use of these commercial assays, and for understanding their patients' IFX and ATI results relative to published data from clinical studies of Remicade.


Assuntos
Anticorpos/sangue , Monitoramento de Medicamentos/métodos , Doenças Inflamatórias Intestinais/imunologia , Infliximab/sangue , Anticorpos/imunologia , Ensaios Clínicos como Assunto , Humanos , Doenças Inflamatórias Intestinais/sangue , Doenças Inflamatórias Intestinais/tratamento farmacológico , Infliximab/imunologia , Infliximab/uso terapêutico , Sensibilidade e Especificidade , Fator de Necrose Tumoral alfa/imunologia
5.
Gastroenterology ; 150(7): 1568-1578, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26946343

RESUMO

BACKGROUND & AIMS: Most patients with Crohn's disease (CD) eventually require an intestinal resection. However, CD frequently recurs after resection. We performed a randomized trial to compare the ability of infliximab vs placebo to prevent CD recurrence. METHODS: We evaluated the efficacy of infliximab in preventing postoperative recurrence of CD in 297 patients at 104 sites worldwide from November 2010 through May 2012. All study patients had undergone ileocolonic resection within 45 days before randomization. Patients were randomly assigned (1:1) to groups given infliximab (5 mg/kg) or placebo every 8 weeks for 200 weeks. The primary end point was clinical recurrence, defined as a composite outcome consisting of a CD Activity Index score >200 and a ≥70-point increase from baseline, and endoscopic recurrence (Rutgeerts score ≥i2, determined by a central reader) or development of a new or re-draining fistula or abscess, before or at week 76. Endoscopic recurrence was a major secondary end point. RESULTS: A smaller proportion of patients in the infliximab group had a clinical recurrence before or at week 76 compared with the placebo group, but this difference was not statistically significant (12.9% vs 20.0%; absolute risk reduction [ARR] with infliximab, 7.1%; 95% confidence interval: -1.3% to 15.5%; P = .097). A significantly smaller proportion of patients in the infliximab group had endoscopic recurrence compared with the placebo group (30.6% vs 60.0%; ARR with infliximab, 29.4%; 95% confidence interval: 18.6% to 40.2%; P < .001). Additionally, a significantly smaller proportion of patients in the infliximab group had endoscopic recurrence based only on Rutgeerts scores ≥i2 (22.4% vs 51.3%; ARR with infliximab, 28.9%; 95% confidence interval: 18.4% to 39.4%; P < .001). Patients previously treated with anti-tumor necrosis factor agents or those with more than 1 resection were at greater risk for clinical recurrence. The safety profile of infliximab was similar to that from previous reports. CONCLUSIONS: Infliximab is not superior to placebo in preventing clinical recurrence after CD-related resection. However, infliximab does reduce endoscopic recurrence. ClinicalTrials.gov ID NCT01190839.


Assuntos
Colectomia/efeitos adversos , Doença de Crohn/tratamento farmacológico , Fármacos Gastrointestinais/administração & dosagem , Infliximab/administração & dosagem , Prevenção Secundária/métodos , Adulto , Colo/patologia , Colo/cirurgia , Colonoscopia , Doença de Crohn/patologia , Doença de Crohn/cirurgia , Método Duplo-Cego , Feminino , Humanos , Íleo/patologia , Íleo/cirurgia , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Recidiva , Resultado do Tratamento
6.
J Acoust Soc Am ; 131(1): 829-36, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22280705

RESUMO

Coupled oscillator models have been used for the low frequency response (50 to 250 Hz) of a guitar. These 2 and 3 mass models correctly predict measured resonance frequency relationships under various laboratory boundary conditions, but did not always represent the true state of a guitar in the players' hands. The model presented has improved these models in three ways, (1) a fourth oscillator includes the guitar body, (2) plate stiffnesses and other fundamental parameters were measured directly and effective areas and masses used to calculate the responses, including resonances and phases, directly, and (3) one of the three resultant resonances varies with neck and side mass and can also be modeled as a bar mode of the neck and body. The calculated and measured resonances and phases agree reasonably well.

7.
Am J Gastroenterol ; 102(10): 2238-46, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17573796

RESUMO

OBJECTIVE: The safety and efficacy of NaP tablets have not been compared with 2L PEG lavage solution. A multicenter, investigator-blinded study was conducted to compare the colon-cleansing efficacy of a new NaP tablet formulation with that of 2L PEG solution plus bisacodyl tablets in adults undergoing colonoscopy. METHODS: A total of 481 patients were randomized to receive either 32 tablets (48 g) of NaP or 2L PEG solution plus 4 (20 mg) bisacodyl tablets. Quality of colon cleansing was assessed using a 4-point scale (1 = excellent, 2 = good, 3 = fair, and 4 = inadequate), and the primary efficacy end point was mean overall colon-cleansing score. Safety assessments included recording of adverse events and changes in biochemical tests and vital signs. RESULTS: A total of 411 patients were included in the efficacy analysis. The mean overall and ascending colon-cleansing scores for NaP tablets were significantly better than PEG plus bisacodyl (overall 1.5 vs 1.8, ascending 1.4 vs 1.8, P < 0.0001 for both). Patients treated with NaP tablets experienced significantly fewer adverse events (66%vs 82%, P= 0.0003) and gastrointestinal symptoms (64%vs 79%, P= 0.0001) compared with patients receiving PEG plus bisacodyl. Patients receiving NaP tablets were significantly less likely to experience abdominal distention, abdominal pain, and vomiting than patients receiving PEG plus bisacodyl (P < 0.0012). Transient fluctuations in laboratory parameters were observed in both treatment groups; however, the fluctuations were more common and of greater magnitude in the NaP group particularly in phosphorous, sodium, and potassium. CONCLUSION: The colon-cleansing efficacy of the new 32-tablet NaP dosing regimen in this study was found to be significantly better than the 2L PEG solution plus bisacodyl tablets regimen. The 32-tablet NaP dosing regimen was associated with fewer adverse events. As expected electrolyte shifts were more common and of greater magnitude in the NaP group compared with the PEG plus bisacodyl group; however, both treatment groups demonstrated significant changes in electrolytes and creatinine.


Assuntos
Bisacodil/administração & dosagem , Catárticos/administração & dosagem , Colonoscopia , Fosfatos/administração & dosagem , Polietilenoglicóis/administração & dosagem , Tensoativos/administração & dosagem , Administração Oral , Adolescente , Adulto , Idoso , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Comprimidos , Resultado do Tratamento
8.
Am J Gastroenterol ; 101(11): 2594-604, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17029618

RESUMO

OBJECTIVE: A residue-free sodium phosphate tablet (RF-NaP) was formulated that lacks microcrystalline cellulose, which can appear as a whitish residue in the colon. A multicenter, randomized, investigator-blinded study was conducted to compare the colon-cleansing efficacy of 40 or 32 tablets of RF-NaP with the marketed 40-tablet NaP treatment regimen. METHODS: Eight hundred sixteen patients were randomized prior to colonoscopy to receive either 40 tablets (60 g) of NaP or RF-NaP or 32 tablets (48 g) of RF-NaP. Colon cleansing was assessed using a 4-point scale based on retained "colonic contents." The primary end point was overall colon-cleansing response rate to treatment (score of excellent/good) versus nonresponse (fair/inadequate). RESULTS: Seven hundred four patients were included in the efficacy analysis. The overall colon-cleansing response rates were comparable among treatment arms (94.5%, 97.0%, and 95.3% for NaP, RF-NaP 40, and RF-NaP 32 tablets, respectively). Ascending colon-cleansing response rates for RF-NaP 40 (95.7%) and 32 tablets (93.6%) were significantly better than for NaP tablets (88.5%, p < 0.03 for both). Patients treated with RF-NaP 32 tablets experienced less pronounced changes in electrolyte levels and fewer adverse events (138/239, 58%) compared with patients receiving NaP (161/238, 68%, p= 0.07) and RF-NaP 40 tablets (156/236, 66%, p= 0.03). The most common adverse events reported were abdominal distention, nausea, abdominal pain, and vomiting. CONCLUSIONS: Based on the safety, efficacy, and patient preferences, the 32-tablet RF-NaP regimen was superior to the 40-tablet RF-NaP and NaP regimen for colon cleansing prior to colonoscopy.


Assuntos
Catárticos/administração & dosagem , Colonoscopia , Fosfatos/administração & dosagem , Adolescente , Adulto , Idoso , Catárticos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Fosfatos/efeitos adversos , Comprimidos
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