Electrochemistry of cyclic triimidazoles and their halo derivatives: A casebook for multiple equivalent centers and electrocatalysis

A family of cyclic triazines, based on the triimidazo[1,2-a:1\u2032,2\u2032-c:1\u2033,2\u2033-e][1,3,5]triazine scaffold, has recently caught attention due to its variegated solid state photoluminescent properties (e.g., crystallization induced emission, fluomechanochromism, dual fluorescence, room temperature ultralong phosphorescence), tuned by proper functionalization of the cyclic core. From an electrochemical point of view, this family of heteroaromatic cyclic triazines is unexplored. A cyclic voltammetry study is here performed aiming to clarify structure/electroactivity relationship. The peculiar molecular structure of this class of molecules offers a multi-approach case study, spanning from multiple equivalent redox site interactions in small hoops (due to ideally C3h symmetry) to carbon-halogen bond reactivity in the presence of catalytic metal electrode surfaces (for \u2013Br and \u2013I derivatives). Results point to a poor heteroannular aromaticity along the rigid, planar cyclotrimer, with each equivalent redox site acting quite independently. An unusually higher electrocatalytic performance of gold with respect to silver electrode for the electrocleavage of carbon-halogen bonds (that decreases by increasing number of halo substituents) is tentatively explained in term of a specific interaction between gold and the nitrogen-rich planar cyclotrimer platform

Amyloid prefibrillar oligomers: The surprising commonalities in their structure and activity

It has been proposed that a "common core" of pathologic pathways exists for the large family of amyloid-associated neurodegenerations, including Alzheimer's, Parkinson's, type II diabetes and Creutzfeldt-Jacob's Disease. Aggregates of the involved proteins, independently from their primary sequence, induced neuron membrane permeabilization able to trigger an abnormal Ca2+ influx leading to synaptotoxicity, resulting in reduced expression of synaptic proteins and impaired synaptic transmission. Emerging evidence is now focusing on low-molecular-weight prefibrillar oligomers (PFOs), which mimic bacterial pore-forming toxins that form well-ordered oligomeric membrane-spanning pores. At the same time, the neuron membrane composition and its chemical microenvironment seem to play a pivotal role. In fact, the brain of AD patients contains increased fractions of anionic lipids able to favor cationic influx. However, up to now the existence of a specific "common structure" of the toxic aggregate, and a "common mechanism" by which it induces neuronal damage, synaptotoxicity and impaired synaptic transmission, is still an open hypothesis. In this review, we gathered information concerning this hypothesis, focusing on the proteins linked to several amyloid diseases. We noted commonalities in their structure and membrane activity, and their ability to induce Ca2+ influx, neurotoxicity, synaptotoxicity and impaired synaptic transmission

The deep circumflex iliac artery free flap in maxillofacial reconstruction: a comparative institutional analysis

Purpose: The aim of the present study was to perform a comparative analysis of the utility, outcomes, and complications of DCIA (deep circumflex iliac artery) flap for the reconstruction of maxillofacial defects between two institutions that continue to use the DCIA flap as a reconstructive resource. Materials and methods: This retrospective analysis included a total of 68 patients (mean age 51.1 years) at the University Hospital of Parma, Parma, Italy, and the University of Maryland, Baltimore, USA, between January 2010 and April 2019. Results: No statistical differences were found in relation to the site of reconstruction (p = 0.09), bone graft quantity (p = 0.93), rehabilitation with dental implants (p = 0.464), length of hospitalization (p = 0.086), BMI (0.677), swallow function (p = 0.419), medical comorbidities (p = 0.933), pre-existing radiation (p = 0.691), adjuvant treatment (p = 0.298), ECOG-PS pre-and post-surgery (p = 0.329; p = 0.545), and flap failure: one partial failure observed (p = 0.412) and donor site morbidities (p = 0.742). A noted trend to increased risk of hernia without the use of a primary mesh repair was observed (p = 0.059). Conclusion: The DCIA free flap represents a useful and reliable reconstructive flap for maxillofacial reconstruction. Reconstructive microvascular surgeons should be proficiently trained in this flap technique for its consideration as a first-line option in maxillofacial reconstruction

Which needle in the treatment of thyroid nodules?

Thyroid nodules are a common finding in general population, with a prevalence of 20% to 70% at ultrasound (US) examination. Many of them are benign but treatment can be necessary to relief compressive symptoms. In the last years, percutaneous ablations have achieved amazing development in the treatment of thyroid nodules as they provide a minimally invasive but effective approach. We aimed to summarize the main aspects related to treatment of thyroid nodules with radiofrequency ablation (RFA), focusing on the use of different types of needles. A narrative review was performed and all papers analyzed reported good results in terms of nodule's size reduction and symptoms relief. No major complications have been reported, even though needles of bigger size seemed related with major risks of post-procedural local edema. Thus, thinner internally cooled multi tined needles [18-19 Gauge (G)] rather than larger needles (14 G) seem to have better results and less complications

Anastomotic leakage in colorectal cancer surgery

The safety of colorectal surgery for oncological disease is steadily improving, but anastomotic leakage is still the most feared and devastating complication from both a surgical and oncological point of view. Anastomotic leakage affects the outcome of the surgery, increases the times and costs of hospitalization, and worsens the prognosis in terms of short- and long-term outcomes. Anastomotic leakage has a wide range of clinical features ranging from radiological only finding to peritonitis and sepsis with multi-organ failure. C-reactive protein and procalcitonin have been identified as early predictors of anastomotic leakage starting from postoperative day 2–3, but abdominal-pelvic computed tomography scan is still the gold standard for the diagnosis. Several treatments can be adopted for anastomotic leakage. However, there is not a universally accepted flowchart for the management, which should be individualized based on patient's general condition, anastomotic defect size and location, indication for primary resection and presence of the proximal stoma. Non‐operative management is usually preferred in patients who underwent proximal faecal diversion at the initial operation. Laparoscopy can be attempted after minimal invasive surgery and can reduce surgical stress in patients allowing a definitive treatment. Reoperation for sepsis control is rarely necessary in those patients who already have a diverting stoma at the time of the leak, especially in extraperitoneal anastomoses. In patients without a stoma who do not require abdominal reoperation for a contained pelvic leak, there are several treatment options, including laparoscopic diverting ileostomy combined with trans-anal anastomotic tube drainage, percutaneous drainage or recently developed endoscopic procedures, such as stent or clip placement or endoluminal vacuum‐assisted therapy. We describe the current approaches to treat this complication, as well as the clinical tests necessary to diagnose and provide an effective therapy

Protonated N,N -Dioxide-4,4 -bipyridine, an Interesting Synthon for the Building of Polar H-Bonded Networks?

A slow liquid-gas diffusion method in strong acid conditions has allowed stabilizing for the first time in the solid state the diprotonated form of the 4,4-bipyridine-N,N-dioxide (bp4do), H(2)bp4do(2+) as two polymophs of the chloride salt (H(2)bp4do)Cl-2, while in the presence of a metallic salt M((III))Br-3 (M = Bi, Sb), the monoprotonated form Hbp4do(+) is mainly stabilized as (Hbp4do)(2)[Sb2Br8] and (H(2)bp4do)(Hbp4do)(4-)[Bi4Br18]center dot 2H(2)O. The dehydration of this last phase leads to (H(2)bp4do)(Hbp4do)(4)[Bi4Br18]. In the structures of (H(2)bp4do)Cl-2 salts, the hydroxyl H atoms point toward the chloride anions leading to close (O)H center dot center dot center dot Cl contacts in the range 1.831-1.839 angstrom. A one-dimensional network of H-bonded Hbp4do(+) cations is found in the structure of (Hbp4do)(2)[Sb2Br8], whereas H-bonded supramolecular cations of five entities are found in the structures of bromobismuthate salts. In all the halometallate structures, X-ray analyses (293 K and 120 K data) did not allow us to locate the acid H atoms of protonated bp4do molecules certainly due to a disorder phenomenon but also revealing an asymmetrical H-bonding situation. The bromobismuthate hybrids are nonlinear optical active with a powder second harmonic generation efficiency being half that of urea

Assessment of severity of acute pancreatitis in a Sars-CoV-2 pandemia

Human and animal rights: Every patient has given permission for publication of information from the medical history as long as it is used for medical research purposes. Informed consent: Informed consent was obtained from all the individual participants of the study

Unusual presentation of a giant jejunal gastrointestinal stromal tumor

Descriviamo il caso clinico di un tumore stromale del digiuno, giunto alla nostra osservazione in emergenza per un quadro di emoperitoneo. L’emoperitoneo era secondario alla rottura spontanea del tumore. Il caso è stato trattato chirurgicamente. Riteniamo che la chirurgia R0 rappresenti la terapia ottimale nei pazienti affetti da queste rare neoplasie. Riteniamo che la laparoscopia debba essere riservata al trattamento delle neoplasie di dimensioni contenute.AIM: Gastrointestinal stromal tumours (GISTs) are rare tumours. Tumour rupture is an additional adverse prognostic factor and should be recorded, regardless of whether it took place before or during surgery. CASE REPORT: A case report of hemoperitoneum from spontaneous rupture of a gastrointestinal stromal tumor of the jejunum is presented. The patient underwent an urgent laparotomy. An "en bloc" resection was performed. CONCLUSION: The information in the literature is examined. Spontaneous rupture of the tumor with concomitant hemoperitoneum is an important prognostic factor in these patients. The hemoperitoneum contributes to a worse prognosis because of its ability to produce peritoneal seeding KEY WORDS: Gist

Commentary on “Acute appendicitis management during the COVID-19 pandemic: A prospective cohort study from a large UK centre”

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