Total synthesis of the Amaryllidaceae alkaloid clivonine

Two syntheses of the Amaryllidaceae alkaloid clivonine (1) are described. Both employ previously reported 7-arylhydrindane 6 as an intermediate but differ in the method employed for subsequent introduction of what becomes the ring-B lactone carbonyl carbon (C7). The synthesis featuring a Bischler–Napieralski reaction for this transformation constitutes the first asymmetric synthesis of natural (+)-clivonine. Crystal structures for compounds (±)-13, (±)-16, (−)-20 and (±)-28 are also reported

Additional Saturday rehabilitation improves functional independence and quality of life and reduces length of stay: a randomised controlled trial

Background Many inpatients receive little or no rehabilitation on weekends. Our aim was to determine what effect providing additional Saturday rehabilitation during inpatient rehabilitation had on functional independence, quality of life and length of stay compared to 5 days per week of rehabilitation.MethodsThis was a multicenter, single-blind (assessors) randomized controlled trial with concealed allocation and 12-month follow-up conducted in two publically funded metropolitan inpatient rehabilitation facilities in Melbourne, Australia. Patients were eligible if they were adults (aged &ge;18 years) admitted for rehabilitation for any orthopedic, neurological or other disabling conditions excluding those admitted for slow stream rehabilitation/geriatric evaluation and management. Participants were randomly allocated to usual care Monday to Friday rehabilitation (control) or to Monday to Saturday rehabilitation (intervention). The additional Saturday rehabilitation comprised physiotherapy and occupational therapy. The primary outcomes were functional independence (functional independence measure (FIM); measured on an 18 to 126 point scale), health-related quality of life (EQ-5D utility index; measured on a 0 to 1 scale, and EQ-5D visual analog scale; measured on a 0 to 100 scale), and patient length of stay. Outcome measures were assessed on admission, discharge (primary endpoint), and at 6 and 12 months post discharge.ResultsWe randomly assigned 996 adults (mean (SD) age 74 (13) years) to Monday to Saturday rehabilitation (n&thinsp;=&thinsp;496) or usual care Monday to Friday rehabilitation (n&thinsp;=&thinsp;500). Relative to admission scores, intervention group participants had higher functional independence (mean difference (MD) 2.3, 95% confidence interval (CI) 0.5 to 4.1, P&thinsp;=&thinsp;0.01) and health-related quality of life (MD 0.04, 95% CI 0.01 to 0.07, P&thinsp;=&thinsp;0.009) on discharge and may have had a shorter length of stay by 2 days (95% CI 0 to 4, P&thinsp;=&thinsp;0.1) when compared to control group participants. Intervention group participants were 17% more likely to have achieved a clinically significant change in functional independence of 22 FIM points or more (risk ratio (RR) 1.17, 95% CI 1.03 to 1.34) and 18% more likely to have achieved a clinically significant change in health-related quality of life (RR 1.18, 95% CI 1.04 to 1.34) on discharge compared to the control group. There was some maintenance of effect for functional independence and health-related quality of life at 6-month follow-up but not at 12-month follow-up. There was no difference in the number of adverse events between the groups (incidence rate ratio&thinsp;=&thinsp;0.81, 95% CI 0.61 to 1.08).ConclusionsProviding an additional day of rehabilitation improved functional independence and health-related quality of life at discharge and may have reduced length of stay for patients receiving inpatient rehabilitation.&nbsp;</p

Coexisting Ankylosing Spondylitis and Gouty Arthritis

Coexsisting ankylosing spondylitis (AS) and gouty arthritis have rarely been reported in the literature previously. We present a 43-year-old male patient with AS who had been diagnosed as having gout based on some clinical and laboratory findings. In this paper, the clinical features of both rheumatic diseases are discussed in light of the recent literature. The gouty arthritis should be considered in the differential diagnosis of acute peripheral arthritis in patients with AS. Turk J Phys Med Rehab 2011;57:111-3

Bromination of 1-cyclopent-1-en-1-ylbenzene and 1-(5-bromocyclopent-1-en-1-yl)benzene and theoretical investigation of the products

The bromination of 1-cyclopent-1-en-1-ylbenzene (4) in different solvents and at different temperatures was accompanied by the evolution of hydrogen bromide and yielded 1-(5-bromocyclopent-1-en-1-yl)benzene (8). Further bromination of 8 gave exclusively 2R(S),5R(S)-1-(1,2,5-tribromocyclopentyl) benzene (11). The experimental results were compared with the theoretical ones based on semi-empirical (MM+ and AM1), Hartree-Fock (HF) and density functional theory (DFT). The formation of 11 was explained by the formation of a weakly bridged bromoniun ion of type 9

Evidence for the formation of a new five-membered ring cyclic allene: Generation of 1-cyclopenta-1,2-dien-1-ylbenzene

Treatment of 1-(2-iodocyclopent-1-en-1-yl)benzene (13), dissolved in benzene, with potassium t-butoxide resulted in the formation of 1-(2-phenylcyclopent-1-en-1-yl) benzene (15) and 1-cyclopent-l-en-1-ylbenzene (5) in a ratio of 1:1

Evidence for the Formation of a New Five-Membered Ring Cyclic Allene: Generation of 1-Cyclopenta-1,2-dien-1-ylbenzene.

Treatment of 1-(2-iodocyclopent-1-en-1-yl)benzene (13), dissolved in benzene, with potassium t-butoxide resulted in the formation of 1-(2-phenylcyclopent-1-en-1-yl) benzene (15) and 1-cyclopent-l-en-1-ylbenzene (5) in a ratio of 1:1