Managing the Unmanageable: A Two-Staged Palliative Resection to Control Life-Threatening Duodenal Bleeding Due to Recurrent Paraganglioma

BACKGROUND This report presents therapeutic decision-making and management of refractory, life-threatening duodenal bleeding in a young man with recurrent metastatic retroperitoneal paraganglioma. CASE REPORT The patient had been symptom free for 8 years after radioactive MIBG (metaiodobenzylguanidine) therapy. Failure of endoscopic or angiographic bleeding control led to urgent need to evaluate possible endocrine functional status, tumor curability, safety of incomplete resection, intra- and postoperative support needs, and anticipated recovery potential and postoperative function. Aside from these considerations, impact of tumor biology, alternative therapeutic options, current management guidelines, and ethical challenges of resource utilization for such complex palliative operative intervention were reviewed. CONCLUSIONS Based on the observed outcomes after an urgent presentation of an unusual tumor-related complication, palliation-intent therapy was justifiable even if significant treatment-related risks were expected and complex resources were required

Chlorido(4,4′,4′′-tri-tert-butyl-2,2′:6′,2′′-terpyridine)­platinum(II) chloride toluene monosolvate

In the title compound, [PtCl(C27H35N3)]Cl·C7H8, the PtII atom is coordinated in a pseudo-square-planar fashion by the N atoms of a 4,4′,4′′-tri-tert-butyl-2,2′:6′,2′′-terpyridine (tbtrpy) ligand and a Cl atom. The Pt—N distance of the N atom on the central pyridine is 1.941 (4) Å, while the peripheral N atoms have Pt—N distances of 2.015 (4) and 2.013 (4) Å. The Pt—Cl bond distance is 2.3070 (10) Å. The cations pack as dimers in a head-to-tail orientation with an inter­molecular Pt⋯Pt distance of 3.2774 (3) Å and Pt⋯N distances of 3.599 (4), 3.791 (4) and 4.115 (4) Å. The solvent mol­ecule is disordered and occupies two positions with a ratio of 0.553 (6):0.447 (6)

Chlorido(4,4′,4′′-tri-tert-butyl-2,2′:6′,2′′-terpyridine)­platinum(II) tetra­fluorido­borate

In the title compound, [PtCl(C27H35N3)]BF4, the PtII atom is in a pseudo-square-planar coordination, which is typical of Pt–terpyridine complexes. The Pt—Cl bond distance is 2.2998 (7) Å. The Pt—N distance of the N atom on the central pyridine is 1.931 (2) Å, while the peripheral N atoms have Pt—N distances of 2.018 (2) and 2.022 (2) Å. The cations pack as dimers in a head-to-tail orientation with an inter­molecular Pt⋯Pt distance of 3.5214 (2) Å and Pt⋯N distances of 3.527 (2), 3.873 (2) and 4.532 (2) Å. In the crystal, cations and anions are linked by weak C—H⋯F hydrogen-bonding inter­actions

Communicating Auditory Impairments Using Electroacoustic Composition

Changes in human sensory perception can occur for a variety of reasons. In the case of distortions or transformations in the human auditory system, the aetiology may include factors such as medical conditions affecting cognition or physiology, interaction of the ears with mechanical waves, or stem from chemically induced sources, such the consumption of alcohol. These changes may be permanent, intermittent, or temporary. In order to communicate such effects to an audience in an accessible, and easily understood manner, a series of electroacoustic compositions were produced. This concept follows on from previous work on the theme of representing auditory hallucinations. Specifically, these compositions relate to auditory impairments that humans can experience due to tinnitus or through the consumption of alcohol. In the case of tinnitus, whilst much is known about the causes and symptoms, the experience of what it is like to live with tinnitus is less explored and those who have acquired the condition may often feel frustration when trying to convey the experience of ‘what it is like’ for them. In terms of impairment from alcohol consumption, whilst there is much hearsay, little research exists on the immediate and short-term effects of alcohol consumption on the human auditory system, despite over half of the UK population reported as consuming alcohol in 2017. The methodology employed to design these compositions draws upon scientific research findings, including experimental and explorative studies involving human participants, coupled with electroacoustic composition techniques. The pieces are typically constructed by mixing field recordings with synthesised materials and incorporating a range of temporal and frequency domain manipulations to the elements therein. In this way, the listener is able to experience the phenomenon in a recognisable context, where distortions of reality can be emulated to varying degrees. It is intended that these compositions can serve as easily accessible and understood examples of auditory impairments and that they might find utility in the communication of symptoms to those who have never experienced the underlying causes or conditions. This presents opportunities for pieces like these to be used in scenarios such as education and public health awareness campaigns

Nevoid basal cell carcinoma syndrome (Gorlin syndrome)

Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms

The role of peptides in bone healing and regeneration: A systematic review

Background: Bone tissue engineering and the research surrounding peptides has expanded significantly over the last few decades. Several peptides have been shown to support and stimulate the bone healing response and have been proposed as therapeutic vehicles for clinical use. The aim of this comprehensive review is to present the clinical and experimental studies analysing the potential role of peptides for bone healing and bone regeneration. Methods: A systematic review according to PRISMA guidelines was conducted. Articles presenting peptides capable of exerting an upregulatory effect on osteoprogenitor cells and bone healing were included in the study. Results: Based on the available literature, a significant amount of experimental in vitro and in vivo evidence exists. Several peptides were found to upregulate the bone healing response in experimental models and could act as potential candidates for future clinical applications. However, from the available peptides that reached the level of clinical trials, the presented results are limited. Conclusion: Further research is desirable to shed more light into the processes governing the osteoprogenitor cellular responses. With further advances in the field of biomimetic materials and scaffolds, new treatment modalities for bone repair will emerge