Pd0-Catalyzed Intramoleculara-Arylation of Sulfones: Domino Reactions in the Synthesis of Functionalized Tetrahydroisoquinolines

A new strategy for the synthesis of tetrahydroisoquinolines based on the Pd(0)-catalyzed intramolecular α-arylation of sulfones is reported. The combination of this Pd-catalyzed reaction with intermolecular Michael and aza-Michael reactions allows the development of two- and three-step domino processes to synthesize diversely functionalized scaffolds from readily available starting materials. KEYWORDS: arylation; domino reactions; nitrogen heterocycles; palladium; sulfone

Palladium-catalysed intramolecular carbenoid insertion of α-diazo α-(methoxycarbonyl)acetanilides for oxindole synthesis

A novel, selective palladium-catalysed carbenoid C(aryl)-H insertion of α-diazo-α-(methoxycarbonyl)acetanilides leading to oxindoles is described

Exploring Partners for the Domino α‐Arylation/Michael Addition Reaction Leading to Tetrahydroisoquinolines

Sulfonates, sulfonamides, and phosphonates have proven useful nucleophiles for palladium‐catalyzed intramolecular α‐arylation reactions leading to tetrahydroisoquinolines. Although the sulfonate α‐arylation reaction can be successfully combined in a domino process with a broad range of Michael acceptors, only vinyl sulfones can be used in Michael additions when starting from sulfonamides. No domino process was developed with the phosphonate derivative. DFT calculations were carried out to gain more insights into the experimental differences observed in the reactions involving these substrates

Torsión tubárica aislada como complicación de un quiste paraovárico en el hospital universitario de Santander, Colombia

Introduction: The paraovarian cyst represents from 10% to 20% of the adnexal masses, it generates symptoms when it causes torsion of the annexes but this is rare. The isolated torsion of the fallopian tubes has an incidence of 1 in 1.5 million women. Objective: To show a case of isolated fallopian tube torsion (IFTT) as a complication of a paraovarian cyst at the University Hospital of Santander. Clinical case: A 17-year old female patient who presents pain in lower hemi-abdomen. After performing the ultrasound, a right paraovarian cyst is found. Her symptomatology improves within 24 hours. Therefore, she is discharged after telling her some recommendations. Two months later, she returns because of pain exacerbation caused by an adnexal mass of 5 centimeters. Now, her lab tests are normal but her new ultrasound reports an enlargement in the ovary and thickened fallopian tubes, so a laparoscopy is performed. This test shows that the right fallopian tube is twisted with necrosis and a right paraovarian cyst of 6 x 5cm. Discussion: The diagnosis of paraovarian cyst is usually incidental by ultrasound; but when there is a torsion complication, pelvic abdominal pain associated with nausea and vomiting is presented. When the physical examination is performed, 42.9% of women present an adnexal mass on palpation. The patient of this clinical case shows abdominal pain, including a tangible adnexal mass, which is evidenced by the ultrasound. For this reason, a laparoscopy is performed. The treatment of the paraovarian cyst is the follow-up; however, if it increases in size or there is persistence, it should be removed surgically due to the risk of torsion of its annexes. If it presents torsion, its handling will depend on the state of the tube. So, if at the moment of performing a distortion in it the violaceous color persists, a salpingectomy and a cystectomy must be performed in this patient. Conclusions: The diagnosis of fallopian tube torsion is performed if the patient has clinical symptoms such as acute pelvic abdominal pain, nausea, vomiting and presence of adnexal mass when performing a digital vaginal examination. Laparoscopy is the treatment of choice, and its management with cystectomy and salpingectomy depends on the vascular commitment of the cyst annexes. [Sepúlveda-Agudelo J, Torrado-Arenas DM, Martínez-Moreno N. Isolated Fallopian Tube Torsion as a Complication of a Paraovarian Cyst in the University Hospital of Santander, Colombia. MedUNAB 2017; 20(3): 393-398].Introducción: El quiste paraovárico representa el 10 al 20% de las masas anexiales, genera síntomas cuando causa torsión de los anexos, pero es poco frecuente, la torsión aislada de las trompas tiene una incidencia de 1 en 1.5 millones de mujeres. Objetivo: Presentar un caso de torsión tubárica aislada como complicación de un quiste paraovárico en el Hospital Universitario de Santander.  Caso clínico: Paciente femenino de 17 años, presenta dolor en hemiabdomen inferior; hallazgo ecográfico, quiste paraovárico derecho; mejora la sintomatología en 24 horas; egreso con recomendaciones; regresa dos meses después por exacerbación del dolor, masa anexial de 5 centímetros, laboratorios normales, ecografía reporta ovario aumentado de tamaño y trompa de paredes engrosadas; se realiza laparoscopia; se encuentra trompa derecha torcida con necrosis y quiste paraovárico derecho de 6 x 5cm. Discusión: El diagnóstico de quiste paraovárico es generalmente incidental por ecografía,  cuando se complica con torsión, se presenta dolor abdominal pélvico asociado a náuseas y vómito, al examen físico el 42.9% de las mujeres presentan a la palpación una masa anexial; la paciente del caso presenta  dolor abdominal, con masa anexial palpable evidenciada en ecografía, por lo cual se realiza laparoscopia. El tratamiento del quiste paraovárico es el seguimiento, sin embargo, si aumentan de tamaño o hay persistencia, debe retirarse quirúrgicamente por el riesgo de torsión de anexos. De presentar torsión el manejo depende del estado de la trompa, al realizar destorsión persiste la coloración violácea, se debe realizar salpingectomía y cistectomía procedimiento realizado en esta paciente. Conclusiones: El diagnóstico de la torsión tubárica se realiza con clínica de dolor abdominal pélvico agudo, náuseas, vómito y presencia de masa anexial al tacto vaginal. La laparoscopia es el tratamiento de elección, cuyo manejo con cistectomía y salpingectomía que depende del compromiso vascular de los anexos. [Sepúlveda-Agudelo J, Torrado-Arenas DM, Martínez-Moreno N. Torsión tubárica aislada como complicación de un quiste paraovárico en el hospital universitario de Santander, Colombia. MedUNAB 2017; 20(3): 393-398]

Incidence of Chlamydia trachomatis and other potential pathogens in neonatal conjunctivitis.

Abstract Objective: Ocular infection in neonatology is a permanent and important health problem. To improve primary attention, prevention, and control, the study of the potential bacterial etiology of all consecutive cases of conjunctivitis was incorporated as a regular procedure in primary care from July 1995 to December 1998. Materials and Methods: Prof. A. Posadas Hospital (Great Buenos Aires) has an average of 4294 births per year. This report analyzes the results obtained in 332 infants (age range, 0–30 d) with conjunctivitis. Clinical conjunctivitis was diagnosed in inpatients and outpatients by the same specialized staff. Isolation and characterization of bacteria were done by conventional microbiologic methods, including specific search for Neisseria gonorrhoeae and Chlamydia trachomatis . Chlamydia trachomatis was studied by antigen immunodetection and polymerase chain reaction, and genotyped by restriction fragment length polymorphism. Results: Conjunctivitis had an incidence (cases per 1000 live births) of 39.6 in 1995, 25.3 in 1996, 15.4 in 1997, and 15.2 in 1998. Microbial growth was detected in 167 (50.3%) of 332 cases. Ocular C. trachomatis infection was detected in 26 cases (7.83%). Five of seven isolates in tissue cultures belonged to type E and two to type G. Bacteria from respiratory ecology were the main isolates: Haemophilus influenzae (16.9%), Streptococcus pneumoniae (12.3%), and Staphylococcus aureus (8.7%). Haemophilus influenzae isolates were not serotyped and 17.2% of them were β-lactamase producers. In 15 cases both H. influenzae and S. pneumoniae were isolated together. Of S. pneumoniae , 4,9% were oxacillin resistant. Conclusions: There has been a decline in the total number of cases of neonatal conjunctivitis, but the disease is still an important health problem. Chlamydia trachomatis also shows a decreasing profile with an incidence of (cases per 1000 live births) 4.39 in 1995, 1.85 in 1996, 1.01 in 1997, and 0.78 in 1998, and a tendency to show more incidence in spring-summer and significant accumulation of cases in babies between 7 and 9 days of age. Haemophilus influenzae alone (12.3%) or associated with S. pneumoniae (4.5%) appears as a prevalent potential bacterial pathogen. A significant accumulation of H. influenzae and S. pneumoniae cases occurs in winter. In 47.6% of cases, there was no bacterial growth. No significant seasonal differences in percentage of negative cultures or among the three-day age groups were detected. Neisseria gonorrhoeae was not found associated with ophthalmia neonatorum in this series

Adv Ther

Purpose To compare visual outcomes and treatment burden between intravitreally administered aflibercept (IVT-AFL) and ranibizumab (RBZ) treat-and-extend (T&E) regimens in patients with wet age-related macular degeneration (wAMD) at 2 years. Methods A systematic literature review was carried out in Medline, EMBASE, and CENTRAL in October 2018. Matching-adjusted indirect comparison (MAIC) and/or individual patient data meta-regression was used to connect ALTAIR (assessing IVT-AFL T&E) with other studies, adjusting for between-trial differences in baseline visual acuity and age or baseline visual acuity, age, and polypoidal choroidal vasculopathy (PCV) status. Sensitivity analyses were conducted to test the robustness of the results, including direct MAIC between IVT-AFL T&E (ALTAIR) and RBZ T&E (CANTREAT and TREX-AMD trials). Results Six randomized controlled trials (RCTs) (ALTAIR, VIEW 1 and 2, CATT, CANTREAT, and TREX) were included in the analysis. IVT-AFL T&E was assessed in one study, ALTAIR (n = 255), while RBZ T&E was assessed in two trials (n = 327). At 2 years, the median difference (95% credibility interval) between IVT-AFL T&E and RBZ T&E regarding the numbers of Early Treatment Diabetic Retinopathy Study (ETDRS) letters gained was not significant (M1: − 2.29 [− 8.10, 3.58]; M2: − 0.55 [− 6.34, 5.29]). IVT-AFL T&E was associated with significantly fewer injections than RBZ-T&E (M1: − 6.12 [− 7.60, − 4.65]; M2: − 5.93 [− 7.42, − 4.45]). Results of the sensitivity analyses were consistent with the main scenarios. Conclusion Patients with wAMD receiving an IVT-AFL T&E regimen achieved and maintained improvement in visual acuity with fewer injections over 2 years compared with RBZ T&E. IVT-AFL T&E may therefore serve as the optimal therapy for wAMD, as it was associated with clinical efficacy and minimized treatment burden

Microcirugia en quemados: artículo de revisión

Burn injuries are an underappreciated trauma that can affect anyone, anytime, anywhere. Severe burns elicit a complex pattern of responses that can last for years after the initial injury. The WHO estimates that 11 million burn injuries of all kinds occur annually worldwide, 180,000 of which are fatal. Microsurgery is a type of surgery that requires a surgical microscope in most cases, in order to develop an adequate anastomosis of blood vessels. Methodology: A systematic review was carried out through various databases from January 2012 to May 2022; The search and selection of articles was carried out in journals indexed in English and Spanish. Results: To meet the need of the recipient site or the burn injury, a microsurgical free flap is used, which includes a multitude of flaps. Among the main causes that require an early transfer of free tissue we find injuries caused by high voltage electrical injuries. The selection of the free flap depends on the usual parameters established by the recipient site. Conclusions: This review offers updated and detailed information on free tissue transfer, how it is subclassified, risk factors for burns, and the main causes of early and late transfer.Antecedentes: Las lesiones por quemaduras son un trauma subestimado que puede afectar a cualquier persona, en cualquier momento y en cualquier lugar. Las quemaduras graves provocan un patrón complejo de respuestas que pueden durar varios años después de la lesión inicial. La OMS estima que en todo el mundo se producen anualmente 11 millones de lesiones por quemaduras de todo tipo, 180.000 de las cuales son mortales. La microcirugía, es un tipo de cirugía del cual se precisa un microscopio quirúrgico en la mayoría de los casos, con el fin de desarrollar una adecuada anastomosis de vasos sanguíneos. Metodología: Se realizó una revisión sistemática a través de diversas bases de datos de enero de 2012 a mayo de 2022; la búsqueda y selección de artículos fue llevada a cabo en revistas indexadas en idioma inglés y español. Resultados: Para satisfacer la necesidad del sitio receptor o la lesión por la quemadura se utiliza colgajo libre microquirúrgico, la cual incluye una multitud de colgajos. Dentro de las principales causas que requieren una transferencia temprana de tejido libre encontramos las lesiones ocasionadas por lesiones eléctricas de alto voltaje. La selección del colgajo libre depende de los parámetros habituales establecidos por el sitio receptor. Conclusiones: La presente revisión ofrece información actualizada y detallada de la transferencia de tejido libre, como se subclasifica, factores de riesgo de las quemaduras y las principales causas de una transferencia temprana y tardía

Analysis of Xq27-28 linkage in the international consortium for prostate cancer genetics (ICPCG) families.

BACKGROUND: Genetic variants are likely to contribute to a portion of prostate cancer risk. Full elucidation of the genetic etiology of prostate cancer is difficult because of incomplete penetrance and genetic and phenotypic heterogeneity. Current evidence suggests that genetic linkage to prostate cancer has been found on several chromosomes including the X; however, identification of causative genes has been elusive. METHODS: Parametric and non-parametric linkage analyses were performed using 26 microsatellite markers in each of 11 groups of multiple-case prostate cancer families from the International Consortium for Prostate Cancer Genetics (ICPCG). Meta-analyses of the resultant family-specific linkage statistics across the entire 1,323 families and in several predefined subsets were then performed. RESULTS: Meta-analyses of linkage statistics resulted in a maximum parametric heterogeneity lod score (HLOD) of 1.28, and an allele-sharing lod score (LOD) of 2.0 in favor of linkage to Xq27-q28 at 138 cM. In subset analyses, families with average age at onset less than 65 years exhibited a maximum HLOD of 1.8 (at 138 cM) versus a maximum regional HLOD of only 0.32 in families with average age at onset of 65 years or older. Surprisingly, the subset of families with only 2-3 affected men and some evidence of male-to-male transmission of prostate cancer gave the strongest evidence of linkage to the region (HLOD = 3.24, 134 cM). For this subset, the HLOD was slightly increased (HLOD = 3.47 at 134 cM) when families used in the original published report of linkage to Xq27-28 were excluded. CONCLUSIONS: Although there was not strong support for linkage to the Xq27-28 region in the complete set of families, the subset of families with earlier age at onset exhibited more evidence of linkage than families with later onset of disease. A subset of families with 2-3 affected individuals and with some evidence of male to male disease transmission showed stronger linkage signals. Our results suggest that the genetic basis for prostate cancer in our families is much more complex than a single susceptibility locus on the X chromosome, and that future explorations of the Xq27-28 region should focus on the subset of families identified here with the strongest evidence of linkage to this region.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are