A Case of Recurrent Neuro-Behçet's Disease after Tooth Extraction

We report a 39-yr-old man with neuro-Behçet's disease (NBD) in remission who developed left-sided ataxia with a sensory deficit about 10 days after tooth extraction. Several years ago, he experienced a similar episode of relapse after tooth extraction. Brain magnetic resonance imaging showed a newly developed right thalamic lesion. In cerebrospinal fluid, lymphocyte-dominant pleocytosis and mild elevation of IgG were found. Immunologic factors may be important in the pathogenesis of NBD because of the time delay between tooth extraction and relapse. Careful observation and prevention are needed before dental procedures in patients with NBD

Cholestatic Hepatitis and Thrombocytosis in a Secondary Syphilis Patient

The incidence of acute hepatitis in syphilis patient is rare. First of all, our patient presented with hepatitis comorbid with thrombocytosis. To our knowledge, this is only the second report of syphilitic hepatitis with thrombocytosis. The 42-yr-old male complained of flulike symptoms and skin eruptions on his palms and soles. Laboratory findings suggested an acute hepatitis and thrombocytosis. Serologic test results were positive for VDRL. He recovered from his symptoms and elevated liver related enzymes with treatment. Because syphilitic hepatitis can present without any typical signs of accompanying syphilis, syphilis should be considered as a possible cause in acute hepatitis patients

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

The Magic of Triisopropyl-1,4,7-Triazacyclononane: Probing the Role of Ni(III) and Ni(I) Centers in Cross-Coupling Catalysis

The last two decades have experienced a dramatic development of nickel-catalyzed cross-coupling reactions involving alkyl substrates, including a wide range of stereoselective transformations. In these reactions, nickel complexes supported by N-donor ligands have been proposed to involve paramagnetic Ni(I) and Ni(III) species as the active intermediates during catalysis. Herein, we report the use of a bulky 1,4,7-triisopropyl-1,4,7-triazacyclononane (iPr3TACN) ligand that allowed the detection and isolation of uncommon organometallic Ni(I) and Ni(III) complexes, which are involved in well-defined oxidative addition, transmetallation, and reductive elimination steps of the proposed catalytic cycle. Moreover, (iPr3TACN)Ni(II) complexes were shown to be efficient catalysts for the alkyl-alkyl Kumada cross-coupling, while a beneficial effect of acetonitrile on the yield of the desired cross-coupled products was observed, likely due to the stabilization of transient Ni(I) species. Overall, these studies provide unambiguous evidence for the involvement of both Ni(III) and Ni(I) organometallic species in Ni-catalyzed alkyl-alkyl cross-coupling reactions

Anagostic Axial Interactions Inhibit Cross-Coupling Catalytic Activity in Square Planar Pyridinophane Nickel Complexes

Herein, we report for the first time the use of the nitrogen-based bidentate molecule [2.2]pyridinophane (N2) as a ligand for metal complexes. Additionally, its improved synthesis allows for electronic modification of the pyridine rings to access the new para-dimethylamino-[2.2]pyridinophane ligand (p-NMe2N2). These ligands bind nickel in an analogous fashion to other pyridinophane ligands, completing the series of tetra-, tri-, and bidentate pyridinophane-nickel complexes. The new compounds exhibit geometrically enforced C-H anagostic interactions between the ethylene bridge protons and the nickel center that are not present in other pyridinophane systems. These ethylene bridge groups also act as an unusual form of steric encumbrance, enforcing square planar geometries in ligand fields that would otherwise adopt tetrahedral structures. In addition, these anagostic interactions inhibit the catalytic performance in Csp3-Csp3 Kumada cross coupling reactions relative to other common bidentate N-ligand platforms, possibly by preventing the formation of the 5-coordinate oxidative addition intermediates

Supporting Information from A multi-functional chemosensor for highly selective ratiometric fluorescent detection of silver(I) ion and dual turn-on fluorescent and colorimetric detection of sulfide

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A multiple target chemosensor for the sequential fluorescence detection of Zn2+ and S2- and the colorimetric detection of Fe3+/2+ in aqueous media and living cells

A novel multiple target sensor, (E)-5-((4-(diethylamino)-2-hydroxybenzyldene) amino)-1H-imidazole-4-carboxamide (DHIC), was synthesized for fluorescence detection of Zn2+ and S2- and colorimetric detection of Fe3+/2+ in aqueous media. DHIC can operate as a turn "on-off" sequential fluorescent sensor for Zn2+ and S2-. Detection limits (1.59 mu M and 8.03 mu M) for Zn2+ and S2- are below the WHO standards (76.0 mu M and 14.7 mu M). The DHIC-Zn2+ complex could be reversibly reused with ethylenediaminetetraacetic acid. Importantly, DHIC could image sequentially Zn2+ and S2- in living cells. Moreover, DHIC displayed a discriminatory color change from pale yellow to orange yellow to Fe3+/2+. The detection limit of DHIC for Fe3+/2+ (0.73 mu M and 1.11 mu M) is far below the EPA drinking water standard (5.37 mu M). The sensor DHIC could be applied to analyze Fe3+ in real samples