Enantioselective Sensing in the Fluorous Phase for Catalyst Screening: Application of a Racemic Fluorescent Probe.

A perfluoroalkyl ketone-based molecular probe was found to show highly enantioselective fluorescent enhancement in the fluorous phase when treated with an amino alcohol generated from the asymmetric reaction of a meso-epoxide with an alkyl amine. The two enantiomeric probes (R)- and (S)-2 were used to screen catalysts for this asymmetric reaction. The use of the probe in the fluorous phase allowed the fluorescent sensing of the products to be conducted away from the other reaction components with minimized interference. It was further found that when (R)- or (S)-2 was used to determine the enantiomeric composition of the amino alcohol product, there was a large nonlinear effect. That is, only when one enantiomer of the substrate was in excess was there a large fluorescence enhancement for the chirality-matched probe-substrate interaction. This allowed the racemic probe rac-2 to be used to evaluate the asymmetric induction in the catalyst screening. The catalyst screening using the fluorescent probes led to the discovery of a more enantioselective and efficient method for the desymmetrization of 1,2-epoxycyclohexane with iPrNH2 to form the corresponding chiral amino alcohol. This work presents a novel method to conduct catalyst screening for asymmetric synthesis and has potential to become a high-throughput process.

Assessment of peri-polyp biopsy specimens of flat mucosa in patients with inflammatory bowel disease.

BACKGROUND AND AIMS: When colon polyps are removed in the setting of inflammatory bowel disease (IBD) involving the large intestine, biopsy sampling of the flat mucosa surrounding such polyps have been recommended, but there are no data to support this practice. METHODS: We reviewed endoscopic and pathologic findings in IBD patients who had dysplastic polyps removed and biopsy sampling of the adjacent flat mucosa. We assessed risk for subsequent neoplasia based on the presence or absence of dysplasia in the peri-polyp flat mucosa and based on number and grade of index polypoid lesions. Kaplan-Meier survival analysis was performed. RESULTS: Fifty-six IBD patients (68% ulcerative colitis [UC]) underwent 102 colonoscopies, in which 129 dysplastic polyps were resected. Five hundred three biopsy procedures of the surrounding flat mucosa were performed (mean, 3.9 biopsy samples per polyp), of which 16 (3.2%) were dysplastic. Thirty-four patients (21 UC) had follow-up in a median of 1.7 years (range, .02-15) and 147 colonoscopies. The presence of dysplasia in peri-polyp biopsy specimens during index colonoscopy was not associated with risk of developing high-grade dysplasia (HGD) or cancer (Pearson χ2 test = .19). The size and number of dysplastic polyps were not predictive of neoplastic outcomes, but the probability of developing subsequent advanced neoplasia for polypoid low-grade dysplasia was 18%, 29%, and 40% by 1, 3, and 5 years, respectively, and for polypoid HGD was 50%, 60%, and 70% by 1, 3, and 5 years, respectively (hazard ratio, 7.0; standard error, 4.8). CONCLUSIONS: In patients with IBD-associated colitis, biopsy sampling of the mucosa adjacent to discrete dysplastic polypoid lesions are low yield and do not predict findings in follow-up examinations. However, the grade of dysplasia of the polyp itself is predictive of subsequent advanced neoplasia.

Decreased Bed Mobility Function Is Associated With Postdischarge Mortality for Cancer Patients in Inpatient Rehabilitation.

OBJECTIVE: The establishment of rehabilitation goals for hospitalized cancer patients depends on accurate medical prognosis and matching goals to clinical timelines. Current tools for estimating prognosis are limited. We hypothesized that bed mobility is a predictor of mortality in cancer patients admitted to inpatient rehabilitation. DESIGN: In a retrospective cohort of 187 subjects with nonneurologic cancer admitted to inpatient rehabilitation, Functional Independence Measure scores and 6-mo mortality were analyzed. RESULTS: In the cohort, survival rate was 71% at 6 mos. In univariate analysis, discharge bed mobility score (odds ratio = 0.75, 95% confidence interval = 0.61-0.90, P = 0.003), bed mobility Functional Independence Measure gain (odds ratio = 0.66, 95% confidence interval = 0.51-0.85, P = 0.002), and bed mobility Functional Independence Measure efficiency (odds ratio = 0.011, 95% confidence interval = 0.00032-0.21, P = 0.006) were inversely associated with 6-mo mortality after discharge from inpatient rehabilitation facility. In multivariate analysis with additional motor Functional Independence Measure items, only bed mobility (odds ratio = 0.73, 95% confidence interval = 0.54-0.97, P = 0.029) and grooming (odds ratio = 0.79, 95% confidence interval = 0.63-0.99, P = 0.041) were independently associated with mortality. CONCLUSIONS: Lower discharge and lower change in bed mobility Functional Independence Measure scores are associated with mortality in cancer patients in inpatient rehabilitation. Bed mobility could serve as a clinical tool for estimating medical prognosis in hospitalized cancer patients and should be validated in prospective studies.

Zoledronic Acid Treatment After Acute Spinal Cord Injury: Results of a Randomized, Placebo-Controlled Pilot Trial.

OBJECTIVE: To determine the effect of intravenous zoledronic acid 5 mg on the extent and course of bone loss after spinal cord injury (SCI). DESIGN: Double-blind, randomized, placebo-controlled parallel-group trial. SETTING: Acute in-patient, tertiary-care rehabilitation hospital. PARTICIPANTS: Convenience sample of 17 in-patients with SCI <12 weeks before randomization; American Spinal Injury Association Impairment scale A, B, or C and medically stable. Twelve patients were evaluated at the primary endpoint at 6 months. METHODS: Patients meeting study criteria were randomly assigned to zoledronic acid 5 mg or matching placebo. Dual x-ray absorptiometry scan and serum for bone markers (type 1 procollagen amino-terminal propeptide, bone-specific alkaline phosphatase, collagen type 1 cross-linked C-telopeptide) were obtained at baseline and after 3 months, 6 months, and the every 6 months for up to 2 years. MAIN OUTCOME MEASURES: The primary endpoint was change in bone mineral density (BMD) at the total hip after 6 months; secondary endpoints were changes in BMD at other skeletal sites and changes in levels of serum bone markers. RESULTS: The group treated with zoledronic acid had a smaller decrease in BMD at 6 months at the total hip than the placebo group (right: -2.2 ± 3.4% versus -8.6 ± 3.5%, respectively, P = .03; left: -3.7 ± 1.0% versus -12.3 ± 6.9%, P = .03). Differences in BMD at the femoral neck were similar (right: -5.1 ± 6.5% versus -20.0 ± 6.4%, P = .01; left: -1.1 ± 3.5% versus -11.1 ± 7.4%, P = .02) with larger bone loss and smaller between group differences at the knee. Zoledronic acid resulted in a decrease in serum levels of both formation and resorption markers. CONCLUSIONS: Zoledronic acid is effective at mitigating bone loss after SCI. Duration of efficacy and activity at different skeletal sites may differ from that observed in able-bodied individuals and needs further study.

Human and Environmental Toxicity of Sodium Lauryl Sulfate (SLS): Evidence for Safe Use in Household Cleaning Products.

Environmental chemical exposure is a major concern for consumers of packaged goods. The complexity of chemical nomenclature and wide availability of scientific research provide detailed information but lends itself to misinterpretation by the lay person. For the surfactant sodium lauryl sulfate (SLS), this has resulted in a misunderstanding of the environmental health impact of the chemical and statements in the media that are not scientifically supported. This review demonstrates how scientific works can be misinterpreted and used in a manner that was not intended by the authors, while simultaneously providing insight into the true environmental health impact of SLS. SLS is an anionic surfactant commonly used in consumer household cleaning products. For decades, this chemical has been developing a negative reputation with consumers because of inaccurate interpretations of the scientific literature and confusion between SLS and chemicals with similar names. Here, we review the human and environmental toxicity profiles of SLS and demonstrate that it is safe for use in consumer household cleaning products.

Patient perceptions of fecal microbiota transplantation for ulcerative colitis.

BACKGROUND: Fecal microbiota transplantation (FMT), the delivery of stool from a healthy prescreened donor to an individual with disease, is gaining increasing recognition as a potential treatment for inflammatory bowel diseases. Our objective was to describe patient interest in and social concerns around FMT. METHODS: We conducted a survey of adults with ulcerative colitis (UC) seen in outpatient clinic at the University of Chicago IBD Center. All English-speaking patients ≥18 years of age were eligible. Subjects completed a written survey in clinic. Ninety-five participants, median age 39 years, 53% female, were enrolled in the study. RESULTS: Forty-four percent and 49% reported excellent or good/satisfactory medical management of their UC, respectively. Forty-six percent participants were willing to undergo FMT as a treatment of UC, 43% were unsure, and 11% were unwilling to undergo FMT. Subjects who had been hospitalized were more willing to undergo FMT, 54% versus 34%, P = 0.035. Primary concerns included the following: adequate screening for infections (41%), cleanliness (24%), and potential to worsen UC (18%); 21% reported no specific concerns. For donor selection, an equal number of participants (46%) preferred whomever their doctor recommended or family member/spouse. CONCLUSIONS: In our center despite reporting satisfactory to excellent disease control with their treatments, the vast majority of patients with UC are interested in or willing to consider FMT. Proof of safety and effectiveness, and failure of other medical therapies are key issues in considering FMT. Strong interest in this as-yet unproven therapy warrants attention and is a pressing priority for clinical research and education.