Strategy for 14C‐labeling of a series of bis(heteroaryl)piperazines

Four bis(heteroaryl)piperazines labeled with carbon‐14 in the 2‐position of imidazole moiety were prepared as part of a 4‐step (or 5‐step) sequence from 5‐hydroxymethyl‐2‐mercapto‐1‐benzylimida‐zole‐[2‐¹⁴C] as a key synthetic intermediate which has been synthesized from potassium [¹⁴C]‐thiocyanate. Copyright © 2011 John Wiley & Sons, Ltd.     

Intracardiac thrombus in adults with the Fontan circulation

OBJECTIVES: To determine the treatment and outcomes of a cohort of adults with the Fontan circulation diagnosed with intracardiac thrombus. BACKGROUND: Formation of thrombus is common after the Fontan operation, albeit little has been published on the treatment and outcomes of these patients once they have developed an intracardiac thrombus. METHODS: We identified all patients who had been converted to the Fontan circulation from the cardiology database at the Toronto Congenital Cardiac Centre for Adults, Toronto, and The Royal Brompton Hospital, London, studying the period from 1981 to 2003. We then reviewed the relevant echocardiograms and medical records. RESULTS: Intracardiac thrombus was identified in 28 of 235 patients with the Fontan circulation, the patients having an average age of 27 plus or minus 9 years. Of the patients, 21 were initially medically treated, 19 with heparin or warfarin, and 2 with thrombolysis, whereas 7 patients underwent immediate surgical removal of the clot. Overall mortality was 18%, with residual clots seen in 39% of surviving patients at 1 year of follow up. At presentation, the haemodynamic stability of each patient with intracardiac thrombus dictated initial strategies for management, with 17% of those with stable presentations undergoing immediate surgical treatment, as opposed to 75% of those with unstable presentations (p-value equals 0.04), as well as correlating with ultimate clinical outcome. The rate of death was 8% in haemodynamically stable patients, versus 75% in haemodynamically unstable patients (p value equals 0.01). CONCLUSION: Formation of intracardiac thrombus is not rare in adults with the Fontan circulation, and carries a significant risk of death, especially in clinically unstable patients. Emphasis on prevention of formation of the clot is warranted.     

Effect of extremely low frequency magnetic field on antioxidant activity in plasma and red blood cells in spot welders

Objective  The purpose of this study was to determine a possible relation between exposure to extremely low frequency magnetic field (ELF-MF) and the human antioxidant activity. Methods  The total serum antioxidant status (TAS), red blood cells (RBCs) glutathione peroxidase (GPX) and superoxide dismutase (SOD) were measured in 46 spot welders who were occupationally exposed to ELF-MF (magnetic field strength = 8.8–84 microTesla (μT), frequency = 50 Hertz (Hz) and electric field strength = 20–133 V/m). The results were compared with a nonexposed ELF-MF control group. The correlation between magnetic field strength and antioxidant activity in RBCs and plasma was then assessed. Results  No significant differences in TAS levels were observed (P value = 0.065). However, in RBCs of exposed group, a significant decrease in SOD and GPX activities was observed (P value = 0.001 and 0.003, respectively). This decrease was measured as 22 and 12.3%, respectively. Furthermore, a significant negative correlation between SOD/GPX activities and magnetic field intensity was observed (coefficients of SOD: −0.625, significance: 0.0001 and coefficients of GPX: −0.348, significance: 0.018). Conclusion  The results of this study indicate that ELF-MF could influence the RBC antioxidant activity and might act as an oxidative stressor. Intracellular antioxidant enzymes such as SOD and GPX were found to be the most important markers involving in this process. The influence of magnetic field on the antioxidant activity of RBCs might occur even at the recommended levels of exposure.     

Opium poisoning following self‐medication of radiation‐induced dermatitis with topical use of opium latex traditional extract; a teaching case

Despite Radiation‐induced dermatitis is a self‐limiting complication, it can be complicated if inappropriate self‐medications have been used such as opium latex traditional extract.     

Uterine contraction pattern as a predictor of the mode of delivery.

OBJECTIVE: To determine whether analysis of the frequency or regularity of uterine contractions can distinguish between women delivering vaginally and women requiring Cesarean section for dystocia. STUDY DESIGN: This was a case-control study. Cases meeting the following criteria were identified: nulliparous women in spontaneous labor, singleton pregnancy, cephalic presentation, 37 to 42 weeks' gestation, Cesarean section for dystocia, a minimum of three analyzable hours of electronically archived cardiotocograph (CTG) prior to onset of the second stage. Cases delivered by Cesarean section for dystocia were each matched with two controls delivering vaginally. The peak of each contraction was visually identified and electronically marked on each CTG trace. A moving average (MTIME) and standard deviation (SDTIME) of five interpeak times were calculated for successive 30-minute periods and plotted against cervical dilatation for each group. RESULTS: Overall, both MTIME and SDTIME fell as labor progressed, with these changes being more marked in the vaginal delivery group. In women requiring oxytocin, the rate of fall of MTIME and SDTIME was significantly greater following oxytocin in the group which subsequently delivered vaginally (slope of MTIME -2.71 pre-oxytocin and -28.95 post-oxytocin, p=0.0004; slope of SDTIME -0.44 and -6.44, p=0.0002). No such change was seen in the Cesarean section group. CONCLUSION: As normal labor progresses, there is a shortening of the intercontraction interval and an increase in contraction regularity. A successful response to oxytocin augmentation may be predicted by the change in contraction pattern following treatment.