ABSTRACT
Background Obstructive sleep apnea (OSA) is present in 60% to 70% of stroke patients. Cerebral vasoreactivity in patients with stroke and OSA has not been well studied and could identify a new pathophysiologic mechanism with potential therapeutic intervention. We aimed to determine whether risk categories for OSA are associated with cerebral vasoreactivity in stroke patients. Methods and Results In this cross-sectional study of a cohort of patients with stroke, we used clinical questionnaires (Sleep Obstructive Apnea Score Optimized for Stroke [SOS] and snoring, tiredness, observed, pressure, bmi, age, neck, gender [STOP-BANG] scores) to assess the risk of OSA and transcranial Doppler to assess cerebral vasoreactivity (breath-holding index and visual evoked flow velocity response). Of the 99 patients included, 77 (78%) had medium or high risk of OSA and 80 performed transcranial Doppler. Mean breath-holding index was 0.52±0.37, and median visual evoked flow velocity response was 10.8% (interquartile range: 8.8-14.5); 54 of 78 (69%) showed impaired anterior circulation vasoreactivity (breath-holding index <0.69) and 53 of 71 (75%) showed impaired posterior circulation vasoreactivity (visual evoked flow velocity response ≤14.0%). There was a significant negative correlation between the risk of OSA calculated by STOP-BANG and the breath-holding index (rS=-0.284, P=0.012). The following variables were associated with low anterior circulation vasoreactivity: dyslipidemia (odds ratio: 4.7; 95% CI, 1.5-14.2) and STOP-BANG score (odds ratio: 1.7 per 1-point increase; 95% CI, 1.1-1.5). Conclusions A high risk of OSA and impaired vasoreactivity exists in the population that has had stroke. Dyslipidemia and STOP-BANG sleep apnea risk categories were independently associated with impaired anterior circulation vasoreactivity.
Subject(s)
Cerebrovascular Circulation , Sleep Apnea, Obstructive/complications , Stroke/etiology , Adult , Aged , Blood Flow Velocity , Cross-Sectional Studies , Dyslipidemias/complications , Female , Humans , Male , Middle Aged , Prognosis , Risk Assessment , Risk Factors , Sleep Apnea, Obstructive/diagnostic imaging , Sleep Apnea, Obstructive/physiopathology , Stroke/diagnostic imaging , Stroke/physiopathology , Ultrasonography, Doppler, TranscranialABSTRACT
A new manganese(II) oxamato dimer possesing an unprecedented Mn2(mu-O2CR)(mu-OH2...O2CR) core has been synthesised, structurally and magnetically characterised, and used as a catalyst for the oxidation of alkanes to alcohols and ketones by ButO2H and O2 in CH2Cl2 at rt.
ABSTRACT
The investigation of an Argentine collection of Enydra anagallis afforded sesquiterpene lactones of the melampolide type two of which were previously known. Their structures were elucidated by spectroscopic methods.
Subject(s)
Asteraceae/chemistry , Lactones/isolation & purification , Sesquiterpenes/isolation & purification , Lactones/chemistry , Sesquiterpenes/chemistry , Spectrum AnalysisABSTRACT
The reaction of 2,3-seco-5 alpha-cholestane-2,3-diol and 4 alpha-methyl-2,3-seco-5 alpha-cholestane-2,3-diol with o-nitrophenyl selenocyanate was studied. The diols were synthesized from cholesterol.
Subject(s)
Cholestanols/chemical synthesis , Nitriles , Secosteroids/chemical synthesis , Chemical Phenomena , Chemistry , Indicators and Reagents , Magnetic Resonance Spectroscopy , Optical Rotation , Spectrophotometry, InfraredABSTRACT
This article reports the transformation of O-acetylisophotosantonin, obtained by photochemical rearrangement of santonin, into plagiochiline N, an ent-2,3-secoaromadendrane isolated from Plagiochila ovalifolia. The synthesis was carried out in a sequence involving as the key steps (a) the substitution of the lactone moiety by a gem-dimethylcyclopropane ring through a synthetic intermediate having a C(6)-C(7) double bond and (b) the ozonolysis of the C(2)-C(3) bond followed by cyclization to the dihydropyran ring characteristic of plagiochiline N. Spectroscopic data of the synthetic product fully coincided with the reported data for the natural product.
Subject(s)
Alkenes/chemical synthesis , Alkenes/isolation & purification , Santonin/chemistry , Thiocyanates/chemical synthesis , Thiocyanates/isolation & purification , Alkenes/pharmacology , Antinematodal Agents/chemistry , Plants, Medicinal/chemistry , Thiocyanates/pharmacologyABSTRACT
Photochemical rearrangement of hydroxy ester 2, easily obtained from santonin (1), afforded butenolide 4, a good starting material for the synthesis of 7,11-guaien-8,12-olides. Compound 4 has been transformed into compound 10, which has been used for the synthesis of podoandin (5) and (+)-zedolactone A (ent-6). Regioselective elimination of the acetyl group on C10 afforded directly podoandin (5). For the synthesis of ent-6, a hydroxyl group has been regio- and stereoselectively introduced at the 4alpha-position through the 3alpha,4alpha-epoxide 15. The basic hydrolysis of the 10-acetyl group in compound 18 took place with concomitant intramolecular conjugated addition of the alkoxide to the butenolide moiety to give ether 19. Cleavage of the 7,10-oxido bridge via the lactone enolate afforded (+)-zedolactone A (ent-6). This synthesis has allowed for the establishment of the absolute stereochemistry of natural zedolactone A as the enantiomer of our synthetic product.