An Environmentally Friendly Route for the Synthesis of Benzofurane Derivatives using Selective Ring Acylation of Resorcinol

International audienceThe synthesis of 2,2-dimethyl-2,3-dihydrobenzofuran- 6-ol, an important intermediate for benzofurane derivatives having pharmaceutical activity, is achieved by an environmentally friendly pathway. Whereas the current synthesis method, based on resorcinol dimethylether, uses or produces harmful, corrosive and dangerous reagents/materials, the procedure proposed here achieves 60% preparative yield for the selective direct ring acylation of resorcinol with isobutyryl chloride, using a solvent-free reaction catalysed by solid acids

Effective training-of-trainers model for the introduction of continuous positive airway pressure for neonatal and paediatric patients in Kenya

Background: Continuous positive airway pressure (CPAP) is a relatively low-cost technology which can improve outcome in neonatal and paediatric patients with respiratory distress. Prior work in a lower middle-income country demonstrated degradation of CPAP skills and knowledge after the initial training. Aims: To determine if a training-of-trainers (ToT) curriculum can decrease gaps in skills and knowledge between first-generation (trained by a United States physician and nurse) and second-generation healthcare providers (trained by local trainers) in Kenya, and to describe the usage pattern, outcome and safety in patients who received CPAP following the trainings. Methods: The first day of training entailed didactic and simulation sessions. On the second day participants were taught how to train others to use CPAP. First- and second-generation healthcare providers were tested on their skills and knowledge. Unpaired t-tests were used to test for equivalence. Prospective data on CPAP usage was collected following the initial trainings. Results: 37 first-generation healthcare providers (16 nurses; 21 physicians, medical/clinical officers) were trained as trainers and 40 second-generation healthcare providers (19 nurses, 21 physicians, medical/clinical officers) trained by first-generation healthcare providers were available for skills and knowledge testing. There were no statistically significant differences between first- and second-generation healthcare providers’ skills (90%, 95% CI 87–93 vs 89%, 95% CI 86–92) or knowledge scores (91%, 95% CI 88–93 vs 90%, 95% CI 88–93). A total of 1111 patients were placed on CPAP mostly by nurses (61%), prematurity/acute respiratory distress syndrome was the most common indication, nasal injury/bleeding (2%) was the most common reported adverse event, and the overall mortality rate was 24%. Conclusion: The ToT model was successful, nurses initiated CPAP most commonly, prematurity with acute respiratory distress syndrome was the most common indication, and adverse events were uncommon.</p