Declaração Universal sobre Bioética e Direitos Humanos e Resolução CNS 466/2012: análise comparativa

Resumo Este artigo objetiva realizar análise comparativa entre a Resolução 466/2012 do Conselho Nacional de Saúde e a Declaração Universal sobre Bioética e Direitos Humanos da Organização das Nações Unidas para a Educação, Ciências e Cultura, no contexto de pesquisas envolvendo seres humanos, para verificar se a resolução aborda os princípios preconizados pela declaração. Os resultados mostram que, enquanto o texto da declaração traz os princípios éticos do respeito à dignidade humana, além de questões biomédicas, biotecnológicas, sanitárias, sociais e ambientais, a resolução ainda é bastante influenciada pela bioética clínica e as práticas biomédicas. Observou-se ausência na resolução dos termos “solidariedade”, “responsabilidade”, “responsabilidade individual”, “diversidade” e “desenvolvimento social”. A declaração utiliza o termo “equidade”, enquanto a resolução apresenta apenas “redução de desigualdades”. Publicada sete anos após a assinatura da declaração, a norma brasileira possui mais conteúdo principialista do que o conteúdo abrangente e político da declaração

New Arylpiperazine Derivatives as Antagonists of the Human Cloned 5-HT 4 Receptor Isoforms

International audienceNew derivatives of arylpiperazine 9 were designed from ML 10302, a potent 5-HT 4 receptor agonist in the gastrointestinal system. Compounds were synthesized by condensation of a number of available arylpiperazines or heteroarylpiperazines with 2-bromoethyl 4-amino-5chloro-2-methoxybenzoate. They were evaluated in binding assays on the recently cloned human 5-HT 4(e) isoform stably expressed in C6 glial cells with [ 3 H]GR 113808 as the radioligand. The affinity values (K i) depended upon the substituent on the aromatic ring. A chlorine atom produced a marked drop in activity (K i > 100 nM), while a m-methoxy group gave a compound with nanomolar affinity (K i) 3 nM). The most potent compounds were the heterocyclic derivatives with pyrimidine, pyrazine, pyridazine, or pyridine moieties (compounds 9r, 9t, 9u, 9x, respectively). K i values for 9a and 9r were determined for the 5-HT 4(a) , 5-HT 4(b) , 5-HT 4(c) , and 5-HT 4(d) receptor isoforms transiently expressed in COS cells. The results indicated that the compounds were not selective. They produced an inhibition of the 5-HT-stimulated cyclic AMP synthesis in the C6 glial cells stably expressing the 5-HT 4(e) receptor and shifted the 5-HT concentration-effect curve on adenylyl cyclase activity with pK D values of 7.44 and 8.47, respectively. In isolated human atrial myocytes, 9r antagonized the stimulatory effect of 5-HT on the L-type calcium current (I Ca) with a K D value of 0.7 nM

Transcatheter aortic valve implantation: early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry.

International audienceAIMS: Transcatheter aortic valve implantation is a therapeutic alternative for high-surgical-risk patients with severe symptomatic aortic stenosis. Two models of prosthesis are currently commercialized in France, which can be implanted either via a transarterial or a transapical approach. The aim of the study was to evaluate in a national French registry the early safety and efficacy of transcatheter aortic valve replacement (AVR) using either the Edwards SAPIEN™ or CoreValve™ in high-surgical-risk patients with severe aortic stenosis. METHODS AND RESULTS: The multicentre national registry was conducted in 16 centres between February 2009 and June 2009, under the authority of the French Societies of Cardiology and Thoracic and Cardio-Vascular Surgery. The primary endpoint was mortality at 1 month. Two hundred and forty-four high-surgical-risk patients (logistic EuroSCORE ≥20%, STS ≥10%, or contra-indication to AVR) were enrolled. Mean age was 82 ± 7 years and 43.9% were female. Edwards SAPIEN and CoreValve were implanted in 68 and 32% of patients, respectively. The approaches used were transarterial (transfemoral: 66%; subclavian: 5%) or transapical in 29%. Device success rate was 98.3% and 30-day mortality was 12.7%. Severe complications included stroke (3.6%), tamponade (2%), acute coronary occlusion (1.2%), and vascular complications (7.3%). Pacemaker was required in 11.8%. At 1 month, 88% of patients were in NYHA class II or less. CONCLUSION: This prospective registry reflects the real-life experience of transcatheter aortic valve implantation in high-risk elderly patients in France. The early results are satisfactory in terms of feasibility, short-term haemodynamic and functional improvement, and safety. Longer term follow-up will be further assessed