Environmental Law

Perhaps following broader legal trends, the Eleventh Circuit\u27s environmental law decisions in this survey period suggest a rise in the importance of state law, both as it might impact enforcement of federal environmental programs and as a source of independent environmental remedies. As an example of the former, the court narrowed the extent to which the absence of a state-level program to implement the federal Clean Water Act\u27s permit requirement shields a member of the regulated community from the obligation to obtain a permit. As an example of the latter, the court affirmed an award of $4,350,000 in punitive damages on a common-law nuisance theory in a case in which the actual damages totaled only$47,000 and the administrative penalties under the stateenforced clean water regulations totaled only $10,000. As with earlier environmental law survey articles, this Article will not review basic statutory schemes unless the Eleventh Circuit has not previously interpreted the statute in question. For readers seeking background on the law, a brief overview of those statutes can be found in earlier survey articles

Synthesis of Nitrogen-Substituted Methylenecyclopropanes by Strain-Driven Overman Rearrangement of Cyclopropenylmethyl Trichloroacetimidates

Nitrogen-substituted methylenecyclopropanes have been prepared by a strain-driven Overman rearrangement of cyclopropenylmethyl trichloroacetimidates. The reaction proceeds at room temperature and without the need of a transition-metal catalyst. Furthermore, it has been shown that C-3-substituted cyclopropenylmethyl trichloroacetimidates undergo a hydrolytic ring-opening reaction to form allenylcarbinols

Clinical Implications of Leaks Following Left Atrial Appendage Ligation with the LARIAT Device

Objectives The aim of this study was to evaluate the incidence and clinical implications of leaks (acute incomplete occlusion, early and late reopenings) following LAA ligation with the LARIAT device. Background Percutaneous LAA ligation with the LARIAT device may represent an alternative for stroke prevention in high-risk patients with atrial fibrillation with contraindications to oral anticoagulation. Methods This was a retrospective, multicenter study of 98 consecutive patients undergoing successful LAA ligation with the LARIAT device. Leaks were defined as the presence of flow as evaluated by transesophageal echocardiography (TEE). TEE was performed during the procedure, at 6 and 12 months, and after thromboembolic events. Results Leaks were detected in 5 (5%), 14 (15%), and 19 (20%) patients at the 3 time points. During follow-up, 5 patients developed neurological events (4 strokes and 1 transient ischemic attack). Two occurred early (1 fatal stroke and 1 stroke with multiple recurrences in the following months), and TEE was not repeated after the events. The remaining 3 occurred late (after 6 months) and were associated with small leaks (<5 mm). In 2 of 3 cases, such a small leak was missed by the standard evaluation on 2-dimensional TEE, being evident only with the aid of 3-dimensional imaging. Conclusions Incomplete occlusion of the LAA after LARIAT ligation is relatively common and may be associated with thromboembolic events. Proper long-term surveillance with careful TEE should be considered to detect leaks, which can be managed with either resumption of oral anticoagulation or percutaneous transcatheter closure

Synthesis of nitrogen-substituted methylenecyclopropanes by strain-driven overman rearrangement of cyclopropenylmethyl trichloroacetimidates

Nitrogen-substituted methylenecyclopropanes have been prepared by a strain-driven Overman rearrangement of cyclopropenylmethyl trichloroacetimidates. The reaction proceeds at room temperature and without the need of a transition-metal catalyst. Furthermore, it has been shown that C-3-substituted cyclopropenylmethyl trichloroacetimidates undergo a hydrolytic ring-opening reaction to form allenylcarbinols

Radiofrequency Energy Applications Targeting Significant Residual Leaks After Watchman Implantation: A Prospective, Multicenter Experience

The aim of this study was to evaluate the efficacy of radiofrequency (RF) energy applications targeting the atrial side of a significant residual leak in patients with acute and chronic evidence of incomplete percutaneous left atrial appendage (LAA) occlusion