Structure-based design and synthesis of antiparasitic pyrrolopyrimidines targeting pteridine reductase 1

The treatment of Human African Trypanosomiasis remains a major unmet health need in sub-Saharan Africa. Approaches involving new molecular targets are important and pteridine reductase 1 (PTR1), an enzyme that reduces dihydrobiopterin in Trypanosoma spp. has been identified as a candidate target and it has been shown previously that substituted pyrrolo[2,3-d]pyrimidines are inhibitors of PTR1 from T. brucei (J. Med. Chem. 2010, 53, 221-229). In this study, 61 new pyrrolo[2,3-d]pyrimidines have been prepared, designed with input from new crystal structures of 23 of these compounds complexed with PTR1, and evaluated in screens for enzyme inhibitory activity against PTR1 and in vitro antitrypanosomal activity. 8 compounds were sufficiently active in both screens to take forward to in vivo evaluation. Thus although evidence for trypanocidal activity in a stage I disease model in mice was obtained, the compounds were too toxic to mice for further development

Good immune restitution but unsatisfactory viral suppression in children on ART in a remote Western Kenya area

Mexico AIDS Conference 200

Baseline hypovitaminosis D is not associated with poor clinical outcomes in osteoarticular infections

OBJECTIVES Although vitamin D is recognized as an important factor in bone health, its role in osteoarticular infections is unclear. We hypothesized that low vitamin D (25-hydroxycholecalciferol) levels are associated with a lower likelihood of treatment success in osteoarticular infections. METHODS This was a retrospective cohort study of patients with orthopedic infections who had a 25-hydroxycholecalciferol level drawn when their infection was diagnosed. Outcomes were determined at early (3-6 months) and late (≥6 months) follow-up after completing intravenous antibiotics. RESULTS We included 223 patients seen during an 11-month period with osteoarticular infections and baseline 25-hydroxycholecalciferol levels. During the initial inpatient management of the infection, hypovitaminosis D was identified and treated. The mean 25-hydroxycholecalciferol level was 23±14ng/ml; 167 (75%) patients had levels <30ng/ml. Overall, infection treatment success was 91% (159/174) at early follow-up and 88% (145/164) at late follow-up. 25-Hydroxycholecalciferol baseline levels were similar in those with and without successful clinical outcomes, both at early (25±15 vs. 21±9ng/ml; p=0.3) and late follow-up (25±15 vs. 23±16ng/ml; p=0.6). CONCLUSIONS To our knowledge this is the first report on hypovitaminosis D and its impact on outcomes of osteoarticular infections. Hypovitaminosis D was frequent in this cohort. With vitamin D repletion, there was no difference in treatment success whether patients had baseline hypovitaminosis or not

Less Anterior Knee Pain with a Mobile-bearing Prosthesis Compared with a Fixed-bearing Prosthesis

Anterior knee pain is one of the major short-term complaints after TKA. Since the introduction of the mobile-bearing TKA, numerous studies have attempted to confirm the theoretical advantages of a mobile-bearing TKA over a fixed-bearing TKA but most show little or no actual benefits. The concept of self-alignment for the mobile bearing suggests the posterior-stabilized mobile-bearing TKA would provide a lower incidence of anterior knee pain compared with a fixed-bearing TKA. We therefore asked whether the posterior-stabilized mobile-bearing knee would in fact reduce anterior knee pain. We randomized 103 patients scheduled for cemented three-component TKA for osteoarthrosis in a prospective, double-blind clinical trial. With a 1-year followup, more patients experienced persistent anterior knee pain in the posterior-stabilized fixed-bearing group (10 of 53, 18.9%) than in the posterior-stabilized mobile-bearing group (two of 47, 4.3%). No differences were observed for range of motion, visual analog scale for pain, Oxford 12-item questionnaire, SF-36, or the American Knee Society score. The posterior-stabilized mobile-bearing knee therefore seems to provide a short-term advantage compared with the posterior-stabilized fixed-bearing knee

Leadership Styles

[First paragraph] Effective schools literature shows clearly that the leadership of the principal is key to the effectiveness of the school (Hoy and Miskell, 1982, and Arnn and Mangieri, 1988). To be effective, principals must use leadership styles appropriate to the situation

Components of Effective Leadership

[First paragraph] The effective schools literature demonstrates that the principal\u27s leadership is key to the revitalization of schools. The purpose of this article is to feature those components of leadership on which principals need to place attention and to provide suggested activities to enhance these components

Proper nutrition can prevent negative health outcomes in young female athletes

Since the onset of Title IX, opportunities have dramatically increased for female athletes, largely to their benefit. However, some negative health outcomes such as disordered eating, chronic menstrual disturbances and low bone mass have been associated with high-level competition among some female athletes, particularly in sports such as gymnastics and cross-country running, where a slender physique or lean body build is important. Adolescent female athletes, in a rapid growth and development phase, may be at greatest risk. We sought to identify athletes at risk, understand the origin of possible negative outcomes and recommend behavioral modifications that promote participation in competitive sports while supporting lifetime health. This review discusses the development and impact of disordered eating and menstrual dysfunction on bone mass in young, competitive, female athletes and provides nutrition recommendations for their energy, carbohydrate, protein, vitamin and mineral intake