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1.
Am J Med Sci ; 2024 May 31.
Article in English | MEDLINE | ID: mdl-38825075

ABSTRACT

BACKGROUND: High blood pressure (BP) induces left atrial structural and functional remodeling that increases susceptibility to atrial arrhythmia. We hypothesized that lower systolic BP (SBP) levels are associated with a lower prevalence of premature atrial contractions (PACs) in patients with hypertension. METHODS: This analysis included 4,697 participants (mean age 62±13.1 years, 50% women, 25.6% blacks) with hypertension from the Third National Health and Nutrition Examination Survey who did not have a prior history of cardiovascular disease (CVD). Multivariable logistic regression was used to examine the cross-sectional association between SBP and prevalence of PACs ascertained from 12-lead resting electrocardiograms. Multivariable Cox proportional hazard analysis was used to examine the association between baseline PACs and CVD mortality. RESULTS: Approximately 1.6% (n=74) of participants had baseline PACs. Patients with SBP ≤140 mmHg had a lower prevalence of PACs than those with SBP ≥140 mmHg (1.1% vs. 1.9%, p-value=0.01). In a multivariable logistic regression model, each 10 mmHg decrease in SBP was associated with a 12% lower odds of PACs (OR (95%CI): 0.88 (0.77-0.99)). During 14 years of follow-up, 645 CVD deaths occurred. In a multivariable-adjusted Cox model, presence of PACs was associated with a 78% increased risk of CVD mortality (HR (95%CI): 1.78 (1.23-2.60)). CONCLUSIONS: In patients with hypertension, lower SBP levels are associated with a lower prevalence of PACs, and presence of PACs is associated with a higher risk of CVD mortality risk. These findings highlight the potential role of BP lowering in the management of cardiac arrhythmias.

2.
J Clin Med ; 13(8)2024 Apr 21.
Article in English | MEDLINE | ID: mdl-38673694

ABSTRACT

Background: The impact of oral anticoagulants (OACs) on cognitive impairment and dementia in patients with atrial fibrillation (AF) is not well characterized. This systematic review aims to address this knowledge gap. Methods: SCOPUS and PubMed searches were conducted to identify articles in the English language investigating the association between the use of OACs and cognitive impairment and dementia. We excluded non-original research studies and studies that did not report data on cognitive impairment or included patients who underwent open heart surgery or had psychiatric illnesses or cancer. Results: Out of 22 studies (n = 606,404 patients), 13 studies (n = 597,744 patients) reported a reduction in cognitive impairment/dementia in those undergoing thromboprophylaxis. Using direct oral anticoagulants (DOACs) was associated with a lower incidence of cognitive impairment in 10 studies (n = 284,636 patients). One study found that patients undergoing dual therapy (n = 6794 patients) had a greater incidence of cognitive impairment compared to those undergoing monotherapy (n = 9994 patients). Three studies (n = 61,991 patients) showed that AF patients on DOACs had a lower likelihood of dementia diagnosis than those on vitamin K antagonists (VKAs). Dementia incidence was lower when VKAs were under good control. Conclusions: The use of oral anticoagulants has the potential to prevent cognitive impairment and dementia in patients with AF. Since most of the published research on this subject is observational in nature, more randomized controlled trials are needed to fully understand the effect of anticoagulants on cognitive function.

3.
J Clin Med ; 13(6)2024 Mar 10.
Article in English | MEDLINE | ID: mdl-38541807

ABSTRACT

Background: Although the link between lead exposure and patterns of cardiovascular disease (CVD) has been reported, its association with silent myocardial infarction (SMI) remains unexplored. We aimed to assess the association between blood lead levels (BLLs) and SMI risk. Methods: We included 7283 (mean age 56.1 ± 2.52 years, 52.5% women) participants free of CVD from the Third National Health and Nutrition Examination Survey. BLL was measured using graphite-furnace atomic absorption spectrophotometry. SMI was defined as ECG evidence of myocardial infarction (MI) without history of MI. The association between SMI and BLLs was examined using multivariable logistic regression. Results: SMI was detected in 120 participants with an unweighted prevalence of 1.65%. Higher BLL correlated with higher SMI prevalence across BLL tertiles. In multivariable-adjusted models, participants in the third BLL tertile had more than double the odds of SMI (OR: 3.42, 95%CI: 1.76-6.63) compared to the first tertile. Each 1 µg/dL increase in BLL was linked to a 9% increase in SMI risk. This association was consistent across age, sex, and race subgroups. Conclusions: Higher BLLs are associated with higher odds of SMI in the general population. These results underscore the significance of the ongoing efforts to mitigate lead exposure and implement screening strategies for SMI in high-risk populations.

4.
J Res Health Sci ; 23(2): e00578, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37571949

ABSTRACT

BACKGROUND: The empirical dietary inflammatory potential (EDIP) score is designed to assess the inflammatory potential of a diet based on the pro- and anti-inflammatory properties of its various components. This study examined the association of EDIP with all-cause mortality in a large, community-based, multiracial sample of the United States population. STUDY DESIGN: A prospective cohort study. METHODS: This analysis included 13155 participants (44.6±18.4 years, 54.21% women, and 40.33% White) without prior history of cardiovascular disease (CVD) from the Third National Health and Nutrition Examination (NHANES III) Survey. A 24-hour dietary recall information was used to calculate EDIP. The National Death Index was employed to identify the date and cause of death. Cox proportional hazard analysis was utilized to evaluate the association between the tertiles of EDIP and all-cause mortality over a median follow-up of 26.6 years. RESULTS: In a model adjusted for demographics and CVD risk factors, a higher EDIP tertile, compared with the lowest tertile, was associated with an increased risk of all-cause mortality (hazard ratio [HR]=1.10; 95% CI: 1.02, 1.19). A standard-deviation increase in EDIP (0.27 units) was related to a 4% increased risk of mortality (HR=1.04; 95% CI: 1.01, 1.08). This association was stronger in older participants compared to younger ones (HR=1.09; 95% CI: 0.98, 1.21 vs. HR=0.89; 95% CI: 0.80, 1.01), respectively, interaction P=0.030)]. CONCLUSION: Pro-inflammatory diet is associated with an increased risk of mortality, especially in the older population. Dietary changes that reduce inflammation may have the potential to reduce the risk of poor outcomes.


Subject(s)
Cardiovascular Diseases , Diet , Female , Humans , Male , Cardiovascular Diseases/etiology , Diet/adverse effects , Follow-Up Studies , Nutrition Surveys , Prospective Studies , Risk Factors , Adult , Middle Aged
5.
Am J Med Sci ; 366(1): 44-48, 2023 07.
Article in English | MEDLINE | ID: mdl-37037375

ABSTRACT

BACKGROUND: Inflammation plays an important role in developing myocardial infarction (MI). This study examined whether a proinflammatory diet is associated with increased risk of myocardial infarction. METHODS: This analysis included 7,134 participants (60.3 ± 13.6 years; 51.8% females) from the third National Health and Nutrition Examination (NHANES-III). The proinflammatory diet was assessed using the empirical dietary inflammatory potential (EDIP) score, calculated from the Food Frequency Questionnaire. MI was defined from electrocardiograms (ECGs) using the Minnesota ECG Classification. The cross-sectional association between levels of EDIP modeled as tertiles and per 1-standard deviation (1-SD) increase in separate models with the risk of MI using multivariable logistic regression analysis. RESULTS: Participants with MI (n=230 (3.2%)) had higher levels of EDIP scores compared to those without MI (0.148 ± 0.241 score units vs. 0.106 ± 0.256 score units, respectively; p=0.01). In multivariable-adjusted models, each 1-SD (0.256 score unit) increase in EDIP was associated with 20% increased odds of MI (OR (95% CI); 1.20 (1.05 to 1.38)). Odds of MI increased as the levels of EDIP tertiles increased, indicating a dose-response relationship (OR (95% CI); 1,41 (1.0 to 1.99) and 1.48 (1.05 to 2.09), respectively). These results were consistent among subgroups of the participants stratified by hypertension, obesity, diabetes, and hyperlipidemia, but effect modification by smoking status was observed (interaction p-value=0.04). CONCLUSIONS: Dietary patterns with high proinflammatory properties are associated with an increased risk of MI. Advocating for low proinflammatory dietary patterns could be an approach for preventing coronary heart disease.


Subject(s)
Diet , Myocardial Infarction , Female , Humans , Male , Nutrition Surveys , Cross-Sectional Studies , Diet/adverse effects , Inflammation/epidemiology , Inflammation/etiology , Myocardial Infarction/etiology , Myocardial Infarction/complications , Risk Factors
6.
J Diabetes Metab Disord ; 21(2): 1249-1254, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36404812

ABSTRACT

Purpose-: This study aimed to examine the association between periodontitis and diabetes mellitus. Methods: Participants with natural teeth in one jaw from the Third United States National Health and Nutrition Examination Survey (1988-1994) were included in this analysis. Participants with moderate (> 4mm attachment loss in ≥ 2 mesial sites or 5mm pocket depth in ≥ 2 mesial sites) or severe (> 6mm attachment loss in ≥ 2 mesial sites and > 5mm pocket depth in ≥ 1 mesial site) periodontitis were classified as having periodontal disease. The rest of the participants were considered without periodontal disease. Diabetes mellitus was defined as fasting glucose ≥ 126mg/dL, hemoglobin A1c ≥ 6.5% or the use of antihyperglycemic medications. Multivariable logistic regression was used to examine the association between periodontitis and diabetes mellitus in all study population and subgroups stratified by demographics and comorbidities. Results: This analysis included 13,000 participants [mean age 43.8 ± 19.1 years, 47.5% male, 30% whites]. About 12.7% (n = 1,656) of the study population had periodontitis, and 9.2% (n = 1,200) had diabetes. In a multivariable-adjusted model, presence (vs. absence) of periodontitis was associated with 66% increased odds of diabetes (OR (95% CI):1.66 (1.43-1.94); p < 0.001). Compared to those without periodontitis, the odds of diabetes among those with severe periodontitis was much higher (OR (95% CI): 2.31(1.72-3.11); p < 0.001) than in those with moderate periodontitis (OR (95% CI): 1.54(1.30-1.82); p < 0.001). Conclusions: Periodontitis is associated with prevalent diabetes in a dose-response fashion, suggesting a bidirectional relationship between those two diseases. Patients with periodontal disease should be counseled regarding their elevated risk of diabetes. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01010-6.

7.
Curr Med Imaging ; 19(5): 486-493, 2022.
Article in English | MEDLINE | ID: mdl-35927895

ABSTRACT

BACKGROUND: Chest High-Resolution Computed Tomography (HRCT) is mandatory for patients with confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and a high Respiratory Rate (RR) because sublobar consolidation is the likely pathological pattern in addition to Ground Glass Opacities (GGOs). OBJECTIVE: The present study determined the correlation between the percentage extent of typical pulmonary lesions on HRCT, as a representation of severity, and the RR and peripheral oxygen saturation level (SpO2), as measured through pulse oximetry, in patients with Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)-confirmed primary (noncomplicated) SARS-CoV-2 pneumonia. METHODS: The present retrospective study was conducted in 332 adult patients who presented with dyspnea and hypoxemia and were admitted to Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia between May 15, 2020 and December 15, 2020. All the patients underwent chest HRCT. Of the total, 198 patients with primary noncomplicated SARS-CoV-2 pneumonia were finally selected based on the typical chest HRCT patterns. The main CT patterns, GGO and sublobar consolidation, were individually quantified as a percentage of the total pulmonary involvement through algebraic summation of the percentage of the 19 pulmonary segments affected. Additionally, the statistical correlation strength between the total percentage pulmonary involvement and the age, initial RR, and percentage SpO2 of the patients was determined. RESULTS: The mean ± Standard Deviation (SD) age of the 198 patients was 48.9 ± 11.4 years. GGO magnitude alone exhibited a significant weak positive correlation with patients' age (r = 0.2; p = 0.04). Sublobar consolidation extent exhibited a relatively stronger positive correlation with RR than GGO magnitude (r = 0.23; p = 0.002). A relatively stronger negative correlation was observed between the GGO extent and SpO2 (r = - 0.38; p = 0.002) than that between sublobar consolidation and SpO2 (r = - 0.2; p = 0.04). An increase in the correlation strength was demonstrated with increased case segregation with GGO extent (r = - 0.34; p = 0.01). CONCLUSION: The correlation between the magnitudes of typical pulmonary lesion patterns, particularly GGO, which exhibited an incremental correlation pattern on chest HRCT, and the SpO2 percentage, may allow the establishment of an artificial intelligence program to differentiate primary SARS-CoV-2 pneumonia from other complications and associated pathology influencing SpO2.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Adult , Middle Aged , COVID-19/diagnostic imaging , Retrospective Studies , Artificial Intelligence , Oxygen Saturation , Tomography, X-Ray Computed/methods
8.
Sci Rep ; 11(1): 20476, 2021 10 14.
Article in English | MEDLINE | ID: mdl-34650073

ABSTRACT

The increased frequency of neurological manifestations, including central nervous system (CNS) manifestations, in patients with coronavirus disease 2019 (COVID-19) pandemic is consistent with the virus's neurotropic nature. In most patients, brain magnetic resonance imaging (MRI) is a sensitive imaging modality in the diagnosis of viral encephalitides in the brain. The purpose of this study was to determine the frequency of brain lesion patterns on brain MRI in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia patients who developed focal and non-focal neurological manifestations. In addition, it will compare the impact of the Glasgow Coma Scale (GCS) as an index of deteriorating cerebral function on positive brain MRIs in both neurological manifestations. This retrospective study included an examination of SARS-CoV-2 pneumonia patients with real-time reverse transcription polymerase chain reaction (RT-PCR) confirmation, admitted with clinicoradiologic evidence of COVID-19 pneumonia, and who were candidates for brain MRI due to neurological manifestations suggesting brain involvement. Brain imaging acquired on a 3.0 T MRI system (Skyra; Siemens, Erlangen, Germany) with a 20-channel receive head coil. Brain MRI revealed lesions in 38 (82.6%) of the total 46 patients for analysis and was negative in the remaining eight (17.4%) of all finally enclosed patients with RT-PCR confirmed SARS-CoV-2 pneumonia. Twenty-nine (63%) patients had focal neurological manifestations, while the remaining 17 (37%) patients had non-focal neurological manifestations. The patients had a highly significant difference (p = 0.0006) in GCS, but no significant difference (p = 0.4) in the number of comorbidities they had. Brain MRI is a feasible and important imaging modality in patients with SARS-CoV-2 pneumonia who develop neurological manifestations suggestive of brain involvement, particularly in patients with non-focal manifestations and a decline in GCS.


Subject(s)
Brain Diseases/etiology , Brain/diagnostic imaging , COVID-19/complications , Adult , Aged , Brain/pathology , Brain Diseases/diagnostic imaging , Brain Diseases/pathology , COVID-19/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/isolation & purification
9.
Int J Biol Macromol ; 184: 558-565, 2021 Aug 01.
Article in English | MEDLINE | ID: mdl-34174299

ABSTRACT

Four novel chitosan hydrogels were successfully synthesized through the cross-linking reaction of chitosan with different concentrations of ethyl 5-(3,5-dihydroxy-1,4-dioxan-2-yl)-2-methylfuran-3-carboxylate. Their structures were confirmed by Fourier transform infrared spectroscopy (FT-IR), 13C Cross polarization magic angle spinning nuclear magnetic resonance spectroscopy (CP/MAS 13C NMR), ultraviolet-visible spectroscopy, thermogravimetric analysis (TGA, DTA), and X-ray diffraction (XRD). Cytotoxicity on hepatocellular carcinoma (HepG-2) cell line and a normal African green monkey kidney (Vero) cell line were studied using the MTT assay. The resultant hydrogels showed a good inhibitory effect comparing to the un-modified parent; the hydrogels with the lowest degree cross-linking (0.125 and 0.25 mol cross-linker per one chitosan residue) showed potent anticancer activity in the HepG2 cells with IC50 of 57.9 and 80.9 µg/ml, respectively. These results show that the newly synthesized cross-linked chitosan derivatives demonstrated more selectivity to the HepG2 than the Vero cells, indicating its potential for Investigation in the cure of hepatocellular carcinoma.


Subject(s)
Antineoplastic Agents/chemical synthesis , Carboxylic Acids/chemistry , Chitosan/chemical synthesis , Schiff Bases/chemistry , Animals , Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacology , Cell Proliferation/drug effects , Cell Survival/drug effects , Chitosan/chemistry , Chitosan/pharmacology , Chlorocebus aethiops , Hep G2 Cells , Humans , Hydrogels/chemistry , Spectroscopy, Fourier Transform Infrared , Vero Cells , X-Ray Diffraction
10.
ISA Trans ; 117: 251-273, 2021 Nov.
Article in English | MEDLINE | ID: mdl-33581892

ABSTRACT

AC corrosion represents a chronic issue that is faced by the buried metallic pipelines that are neighboring by the high voltage overhead transmission lines (HVOHTLs). In this paper a potassium hydroxide polarization cell (KOH-PC) is employed on the pipeline to mitigate the generated voltage from the power lines' intrusion with the buried pipeline. This work further investigates an integrated system to exploit the discharged energy for compensating the cathodic protection disturbances where a portion of this energy may be converted to DC form and reapplied on the pipeline as a cathodic protection voltage. This paper also presents a comparative analysis of different KOH-PCs' models with different controllers to provide the guidelines for deciding which one of these techniques is more suitable for mitigating the induced voltage and improving the cathodic protection distribution during normal and fault operating conditions of transmission lines. The applied controllers are the artificial-neural-network (ANN), Fuzzy-logic-controller (FLC), and​ adaptive-neuro-fuzzy inference system (ANFIS). The proposed model's performance is implemented through modeling and simulating on MATLAB software with the experimental measurements from the comparative analysis. The ANFIS controller is more precise in differentiation with other controllers in compensating for the CP disturbances.

11.
Int J Biol Macromol ; 163: 2180-2188, 2020 Nov 15.
Article in English | MEDLINE | ID: mdl-32946942

ABSTRACT

Two novel chitosan Schiff bases namely chitosan pyrazolo[3,4-b]quinoxaline Schiff base (Ch-PQ1) and chitosan phenyl-1H-pyrazolo[3,4-b]quinoxaline Schiff base (Ch-PQ2) were synthesized as a modification of chitosan in order to increase its ability in heavy metal removal from wastewater. Their structures were characterized by FT-IR spectroscopy, TGA analysis and X-ray diffraction. They were tested for the removal of hexavalent chromium from synthetic samples. In addition pH conditions, polymer dosage, Cr (VI) initial concentration and contact time were studied as a key factor for the adsorption process. Kinetic studies of the removal process were also clarified. Furthermore, experimental equilibrium data were fitted to Langmuir and Freundlich adsorption isotherms. Both chitosan Schiff bases showed high removal efficiency, the result indicated that Cr (VI) removal using Ch-PQ1 and Ch-PQ2 was 96.4% and 98.8% respectively.


Subject(s)
Chitosan/chemistry , Chromium/isolation & purification , Wastewater/chemistry , Water Pollutants, Chemical/isolation & purification , Chitosan/chemical synthesis , Chitosan/pharmacology , Chromium/toxicity , Schiff Bases/chemical synthesis , Schiff Bases/chemistry , Schiff Bases/pharmacology , Spectroscopy, Fourier Transform Infrared , Water Pollutants, Chemical/toxicity , Water Purification/methods
12.
Heliyon ; 6(3): e03417, 2020 Mar.
Article in English | MEDLINE | ID: mdl-32181380

ABSTRACT

The problem of AC corrosion remains motivating for researchers because many factors influence the corrosion rate for buried pipelines due to the interference with overhead high voltage transmission lines (OHVTLs). Many researchers study the mechanisms of induced alternating current (AC) voltages, which are summarized as capacitive, inductive, and conductive coupling. In this work, only the induced AC voltage on the pipelines due to inductive coupling in steady-state conditions is studied. A holistic mathematical model for the pipelines, power lines, mitigation equipment for the induced voltage, and cathodic protection (CP) is illustrated. Potassium hydroxide polarization cells are electrically represented because these cells are considered the most common mitigation device for discharging the induced AC voltage from the pipeline to the soil. The overall model is implemented using MATLAB. The results show the profiles of induced AC voltage along the pipeline, the CP for the pipeline, the points of maximum voltage, and the influence of installing the AC mitigation units on the CP performance.

13.
Org Biomol Chem ; 17(18): 4629-4639, 2019 05 08.
Article in English | MEDLINE | ID: mdl-31020305

ABSTRACT

A one-pot approach for ortho-coupling of arenes with non-actived N-nucleophiles has been developed using sequential iron and copper catalysis. Regioselective ortho-activation of anisoles, anilines and phenols was achieved through iron(iii) triflimide catalysed iodination, followed by a copper(i)-catalysed, ligand-assisted coupling reaction with N-heterocycle, amide and sulfonamide-based nucleophiles. The synthetic utility of this one-pot, two-step method for the direct amination of ortho-aryl C-H bonds was demonstrated with the late-stage functionalisation of 3,4-dihydroquinolin-2-ones. This allowed the preparation of a TRIM24 bromodomain inhibitor and a series of novel analogues.

14.
Asian Pac J Cancer Prev ; 19(10): 2991-2999, 2018 Oct 29.
Article in English | MEDLINE | ID: mdl-30371994

ABSTRACT

With no sharp cure, breast cancer still be the major and the most serious life-threatening disease worldwide. Colorectal is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women. In the present investigation, colon cancer cells (CaCo-2) and breast cancer cells (MCF-7) were treated with elevated doses of metformin (MET) for 48h. Cell count was assessed using trypan blue test, and the cytotoxicity was evaluated using MTT assay. Methylation-specific PCR was performed on the bisulfite-treated DNA against two tumor suppressor genes; RASSF1A and RB. Results indicated that: in breast cancer, the cell count was decreased significantly (P>0.005) after being treated with 5, 10, 20, 50, and 100 mM of MET. The elevated concentration had increased reduction percentages on the MCF-7 cells, as 5 mM and 100 mM have yielded 35% and 93.3% reduction in cell viability, respectively. Colon cancer cells have responded to the doses of MET differently, as for the 5 mM and the 100 mM, it gave 88% and 60% reduction in cells viability, respectively. Cytotoxicity assay revealed that 5 mM and 100 mM of MET caused breast cancer cells to loss 61.53% and 85.16% of its viability, respectively, whereas colon cancer cells have responded to the 5 mM and 100 mM of MET by reducing the cells viability with 96.91% and 96.24%, respectively. No RB promoter methylation was detected in colon cells, while RASSF1A was partially methylated. In the MCF-7 breast cancer cells, both RASSF1A and RB were partially methylated.


Subject(s)
Breast Neoplasms/drug therapy , Colorectal Neoplasms/drug therapy , DNA Methylation/drug effects , Metformin/pharmacology , Caco-2 Cells , Cell Line, Tumor , Cell Survival/drug effects , Female , Humans , MCF-7 Cells , Promoter Regions, Genetic/drug effects
15.
Pain Med ; 19(3): 561-568, 2018 03 01.
Article in English | MEDLINE | ID: mdl-28520955

ABSTRACT

Objective: Effective postoperative pain control reduces postoperative morbidity. In this study, we investigated the effects of intrathecal morphine, ketamine, and their combination with bupivacaine for postoperative analgesia in major abdominal cancer surgery. Study Design: Prospective, randomized, double-blind. Setting: Academic medical center. Patients and Methods: Ninety ASA I-III patients age 30 to 50 years were divided randomly into three groups: the morphine group (group M) received 10 mg of hyperbaric bupivacaine 0.5% in 2 mL volume and 0.3 mg morphine in 1 mL volume intrathecally. The ketamine group (group K) received 0.1 mg/kg ketamine in 1 mL volume instead of morphine. The morphine + ketamine group (group K + M) received both 0.3 mg morphine and 0.1 mg/kg ketamine in 1 mL volume intrathecally. Postoperative total morphine consumption, first request of analgesia, visual analog score (VAS), and side effects were recorded. Results: Total PCA morphine was significantly decreased in group M + K compared with groups M and K. Time to first request of analgesia was prolonged in groups M and M + K compared with group K (P < 0.001). VAS in group M + K was reduced from two to 24 hours, and in group M from 12 and 18 hours postoperation compared with group K, with an overall good analgesia in the three groups. Sedation was significantly higher in group M + K compared with group M until six hours postoperation. No other side effects were observed. Conclusions: Adding intrathecal ketamine 0.1 mg/kg to morphine 0.3 mg in patients who underwent major abdominal cancer surgery reduced the total postoperative morphine consumption in comparison with either drug alone, with an overall good postoperative analgesia in all groups, with no side effects apart from sedation.


Subject(s)
Abdominal Neoplasms/surgery , Analgesics/administration & dosage , Ketamine/administration & dosage , Morphine/administration & dosage , Pain, Postoperative/prevention & control , Adult , Analgesia/methods , Bupivacaine/administration & dosage , Digestive System Surgical Procedures/adverse effects , Double-Blind Method , Female , Humans , Injections, Spinal , Male , Middle Aged
16.
J Org Chem ; 82(14): 7529-7537, 2017 07 21.
Article in English | MEDLINE | ID: mdl-28661157

ABSTRACT

A general and regioselective method for the chlorination of activated arenes has been developed. The transformation uses iron(III) triflimide as a powerful Lewis acid for the activation of N-chlorosuccinimide and the subsequent chlorination of a wide range of anisole, aniline, acetanilide, and phenol derivatives. The reaction was utilized for the late-stage mono- and dichlorination of a range of target compounds such as the natural product nitrofungin, the antibacterial agent chloroxylenol, and the herbicide chloroxynil. The facile nature of this transformation was demonstrated with the development of one-pot, tandem, iron-catalyzed dihalogenation processes allowing highly regioselective formation of different carbon-halogen bonds. The synthetic utility of the resulting dihalogenated aryl compounds as building blocks was established with the synthesis of natural products and pharmaceutically relevant targets.

17.
Org Biomol Chem ; 15(14): 3035-3045, 2017 Apr 05.
Article in English | MEDLINE | ID: mdl-28304410

ABSTRACT

The amino substituted bicyclo[4.3.0]nonane is a molecular scaffold found in a wide range of natural products and medicinal agents. Despite this, synthetic methods for the general preparation of this structural motif are sparse. Here we evaluate a diastereoselective approach for the preparation of vinylsilyl derived aminobicyclo[4.3.0]nonanes using a one-pot multi-bond forming process involving a Pd(ii)-catalysed Overman rearrangement, a Ru(ii)-catalysed ring closing enyne metathesis reaction, followed by a hydrogen bonding directed Diels-Alder reaction. We show that a benzyldimethylsilyl-substituted alkene analogue is amenable to further functionalisation and the late stage generation of diverse sp3-rich, drug-like aminobicyclo[4.3.0]nonane scaffolds with up to six stereogenic centres.

18.
Chemistry ; 23(5): 1044-1047, 2017 Jan 23.
Article in English | MEDLINE | ID: mdl-27918637

ABSTRACT

A mild, efficient and regioselective method for para-amination of activated arenes has been developed through a combination of iron and copper catalysis. A diverse range of products were obtained from an operationally simple one-pot, two-step procedure involving bromination of the aryl substrate with the powerful Lewis acid iron(III) triflimide, followed by a copper(I)-catalysed N-arylation reaction. This two-step dehydrogenative process for the regioselective coupling of aromatic C-H bonds with non-activated amines was applicable to anisole-, phenol-, aniline- and acetanilide-type aryl compounds. Importantly, the arene substrates were used as the limiting reagent and required no protecting-group manipulations during the transformation.

19.
Molecules ; 21(6)2016 May 25.
Article in English | MEDLINE | ID: mdl-27231891

ABSTRACT

Chitosan was reacted with four concentrations (2.5, 5, 10 and 20 mmol) of glutamic acid resulting in four types of glutamic-chitosan hydrogels (GCs), the activity of the resulted compounds on the removal of copper(II) and nickel(II) from wastewater were tested. The results indicated that by increasing glutamic acid concentration from GCs-1 to GCs-4, the efficiency of removing Cu(II) and Ni(II) were decreased, which may be due to a decrease in the pore size of the hydrogels as a result of the increased degree of crosslinking.


Subject(s)
Hydrogels/chemistry , Wastewater/chemistry , Water Pollutants, Chemical/chemistry , Water Purification , Chitosan/chemistry , Copper/chemistry , Humans , Nickel/chemistry
20.
Org Biomol Chem ; 14(12): 3284-97, 2016 Mar 28.
Article in English | MEDLINE | ID: mdl-26932788

ABSTRACT

A diastereoselective synthesis of highly substituted aminobicyclo[4.3.0]nonanes has been attained using a one-pot multi-bond forming process. A four-step synthetic route was developed for the efficient synthesis of a series of C-7 substituted hept-2-en-6-yn-1-ols. These compounds were then investigated as substrates for a one-pot, three-step tandem process involving a palladium(ii)-catalysed Overman rearrangement, a ruthenium(ii)-catalysed ring closing enyne metathesis reaction followed by a hydrogen bond directed Diels-Alder reaction. The optimisation of the one-pot process has allowed the rapid preparation of a library of aminobicyclo[4.3.0]nonanes with significant molecular complexity and up to four stereogenic centres.

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