Aqueous phase synthesis of polysubstituted pyrimidines/pyrrolidines catalyzed by β-cyclodextrin

Highly substituted pyrimidine/pyrrolidine derivatives were synthesized for the first time in water under neutral conditions by the reaction of aromatic amines, dimethyl/diethyl acetylene dicarboxylates, formaldehyde mediated by β-cyclodextrin (β-CD) in good to excellent yields. β-Cyclodextrin can be recovered and reused without any loss of catalytic activity. The β-Cyclodextrins employed were inexpensive and readily available when compared to other types of cyclodextrins (α, γ)

β-Cyclodextrin catalyzed synthesis of substituted indoles in aqueous medium

β-Cyclodextrin catalyzed synthesis of indole derivatives from indole, aldehyde and N-methylaniline is reported. The β-cyclodextrin can be recovered and reused without significant loss of catalytic activity, and it is inexpensive, readily available when compared to other cyclodextrins (α, γ)

Stroke Centers of Excellence in the United States: Certification, Access and Outcomes

Introduction: Stroke is a leading cause of morbidity, mortality and healthcare costs in the United States. Evidence suggests that certified stroke centers have improved patient outcomes relative to non-certified hospitals. Our study explains the process, associated cost, quality and geographic proclivities of different certifying organizations. Methods: Data was collected from published literature, information on certifying organizations’ websites and through direct communication with representatives of The Joint Commission (TJC), Det Norske Veritas and Germanischer Lloyd (DNV-GL), and Healthcare Facilities Accreditation Program (HFAP). Geographic mapping of thrombectomy capable centers and comprehensive stroke centers was performed with the ArcGIS online tool. Results: Among the three certifying organizations, standards for recognition as acute, primary, thrombectomy capable and comprehensive stroke centers are not standardized. At the time of this review, there were 1406 TJC-certified stroke centers, 241 DNV-GL certified stroke centers and 66 HFAP-certified stroke centers in the United States. Cost for certification was similar with price scaled by complexity of capabilities. Quality metrics revealed a significantly higher rate of tPA administration and shorter door-to-needle time for TJC and DNV-GL centers than HFAP. All primary stroke centers exhibited improved in-hospital, 30-day and 1-year mortality when compared to non-stroke centers. Discussion: Despite lack of standardization of criteria between organizations, certification provides a mechanism for ensuring hospitals deliver higher standards of stroke care. Understanding variations in quality and scope of different organizations enables targeting of at-risk regions to maximize access and availability of care

Transpapillary drainage has no added benefit on treatment outcomes in patients undergoing EUS-guided transmural drainage of pancreatic pseudocysts: a large multicenter study

Background and Aims The need for transpapillary drainage (TPD) in patients undergoing transmural drainage (TMD) of pancreatic fluid collections (PFCs) remains unclear. The aims of this study were to compare treatment outcomes between patients with pancreatic pseudocysts undergoing TMD versus combined (TMD and TPD) drainage (CD) and to identify predictors of symptomatic and radiologic resolution. Methods This is a retrospective review of 375 consecutive patients with PFCs who underwent EUS-guided TMD from 2008 to 2014 at 15 academic centers in the United States. Main outcome measures included TMD and CD technical success, treatment outcomes (symptomatic and radiologic resolution) at follow-up, and predictors of treatment outcomes on logistic regression. Results A total of 375 patients underwent EUS-guided TMD of PFCs, of which 174 were pseudocysts. TMD alone was performed in 95 (55%) and CD in 79 (45%) pseudocysts. Technical success was as follows: TMD, 92 (97%) versus CD, 35 (44%) (P = .0001). There was no difference in adverse events between the TMD (15%) and CD (14%) cohorts (P = .23). Median long-term (LT) follow-up after transmural stent removal was 324 days (interquartile range, 72-493 days) for TMD and 201 days (interquartile range, 150-493 days) (P = .37). There was no difference in LT symptomatic resolution (TMD, 69% vs CD, 62%; P = .61) or LT radiologic resolution (TMD, 71% vs CD, 67%; P = .79). TPD attempt was negatively associated with LT radiologic resolution of pseudocyst (odds ratio, 0.11; 95% confidence interval, 0.02-0.8; P = .03). Conclusions TPD has no benefit on treatment outcomes in patients undergoing EUS-guided TMD of pancreatic pseudocysts and negatively affects LT resolution of PFCs

Aqueous phase synthesis of polysubstituted pyrimidines/pyrrolidines catalyzed by β-cyclodextrin

Highly substituted pyrimidine/pyrrolidine derivatives were synthesized for the first time in water under neutral conditions by the reaction of aromatic amines, dimethyl/diethyl acetylene dicarboxylates, formaldehyde mediated by β-cyclodextrin (β-CD) in good to excellent yields. β-Cyclodextrin can be recovered and reused without any loss of catalytic activity. The β-Cyclodextrins employed were inexpensive and readily available when compared to other types of cyclodextrins (α, γ)

An environmentally benign and efficient synthesis of 2-thio-substituted benzothiazoles

An environmentally benign, simple and highly efficient method for the synthesis of 2-thio-substituted benzothiazole derivatives has been achieved in good to excellent yields by reacting a series of aryl halides with 2-mercapto benzothiazole, using recyclable CuFe2O4 nanoparticles under ligand free conditions in PEG-400 as solvent. In the present protocol, the copper ferrite nanoparticles can be recovered and reused up to four cycles without significant loss of activity

Macrocyclic toolbox from epothilone fragment identifies a compound showing molecular interactions with actin and novel promoters of apoptosis in patient-derived brain tumor cells

A simple, practical stereoselective synthesis of the epothilone fragment is developed to obtain a diverse set of expanded 18-membered macrocyclic compounds. These macrocycles contain the C5–C8 sub-unit of epothilone and an additional amino acid moiety incorporated in the 18-membered macrocycle, which allows the synthesis of several analogs with a variation in the chiral side chain. The epothilone fragment was obtained by using an enantiopure epoxide, which was subjected to a regioselective opening, giving the key derivative. Finally, the synthesis of the 18-membered macrocyclic ring was achieved by employing two key steps: (i) acylation with an N-allylated amino acid moiety, and (ii) a ring-closing metathesis (RCM) approach. Computational studies of the macrocyclic compounds obtained from this study with actin give rise to the proposed molecular interactions with the target protein. Further, the screening of our chemical toolbox from this program (i.e., the final products and several intermediates) identified several compounds as promoters of apoptosis in patient-derived brain tumor glioma cells

Diffusion Tensor imaging findings in a patient with Panayiotopoulos syndrome

<div>www.asnweb.org/i4a/pages/index.cfm?pageid=3666<br></div><div><br></div>Introduction: Panayitopoulos syndrome or benign epilepsy with occipital paroxysms is a common benign epilepsy syndrome described in children. Patients generally have infrequent seizures, mainly occurring at night with multitude of autonomic symptoms such as emesis, pallor, tachycardia and visual hallucinations. Inter-ictal EEG findings most commonly demonstrate nearly continuous unilateral or bilateral high voltage spike-wave discharges from the occipital or posterior temporal regions. We present a patient with clinical symptoms and electroencephalographic (EEG) findings consistent with Panayitopoulos syndrome and diffusion tensor imaging of her brain showing attenuation of fibers over the right temporal-occipital area and decreased thickness of the right occipital lobe. Previous scientific literature on Panayitopoulos syndrome has discussed the brain MRI and functional MRI findings. However, to the best of our knowledge, diffusion tensor studies in patients with Panayiotopoulos syndrome have not been reported. Our case report suggests that subtle structural lesions may be a part of the pathophysiology of Panayiotopoulos syndrome