The Incidence of Acute Pancreatitis After Device Assisted Enteroscopy: a Systematic Review and Meta-analysis.

Background: The diagnosis of small bowel diseases is challenging and device assisted enteroscopy (DAE) is a technique for visualizing the entire small bowel. DAE is considered as a safe procedure and the reported rate of adverse events associated with DAE in the literature is low. Objective: The present study tried to investigate the actual incidence of AP after DAE with a systematic review and meta-analysis of available relevant studies. Methods: Studies were searched through the PubMed, EMBASE, and Cochrane library databases. The following data were extracted from all eligible studies: author, country, publication year, publication type, study design, type of DAE used, route of DAE, number of patients with AP after DAE, and number of patients with hyperamylasemia after DAE.A random-effects model with RStudio version 4.2.0 was performed in all analyses. Heterogeneity was assessed using the I2 test. The risk of bias was assessed by the Newcastle-Ottawa Scale criteria and the publication bias was assessed by the Egger test. Results: Twenty three studies involving a total of 11145 patients were included in the analysis. The overall, pooled AP rate after DAE was 1% (95% CI:0-1%). There was significant heterogeneity among the studies (I2 = 65%; P < 0.01).The pooled AP rate was 1% (95% CI:0-2 %)in peroral route group. The pooled proportion of patients having hyperamylasemia after DAE was 29% (95% CI: 16-46%).Among the patients who had hyperamylasemia AP were identified in 2% (95% CI: 0-6%) of patients. Conclusion: The incidence of AP after DAE is about 1%. Hyperamylasemia is a common change in the patients undergoing DAE and only 2% of the patients with hyperamylasemia present with AP.

Copper-Catalyzed Cross-Coupling of Alkyl and Phosphorus Radicals for C(sp3)-P Bond Formation.

A CuI-catalyzed cross-coupling of alkyl- and phosphorus-centered radicals for C(sp3)-P bond formation is introduced. Diacyl peroxides, generated in situ from aliphatic acids and H2O2, serve as a source for alkyl radicals and also an initiator for the generation of phosphorus radicals from H-P(O) compounds.

Copper-Catalyzed Vicinal Cyano-, Thiocyano-, and Chlorophosphorylation of Alkynes: A Phosphinoyl Radical-Initiated Approach for Difunctionalized Alkenes.

A copper-catalyzed difunctional cyano-, thiocyano-, and chlorophosphorylation reaction of alkynes with P(O)-H compounds and coupling partners (TBACN, TMSNCS, TMSCl) is described. The reaction introduces versatile groups (-P(O)R2 and -CN, -SCN, or -Cl) to form tri- and tetrasubstituted alkenyl phosphine oxides/phosphonates regio- and stereoselectively.

Copper-Catalyzed Oxidative sp3-Carbon Radical Cross-Coupling with Trialkylphosphites Leading to α-Phosphonyl 1,3-Dicarbonyl Compounds.

A copper-catalyzed radical Csp3-H/P(OR)3 cross-coupling reaction for the formation of Csp3-P bonds is described. A range of 1,3-dicarbonyl compounds and trialkylphosphites were coupled in this fashion to give the corresponding products in moderate to good yields. This protocol provides direct access to α-phosphonyl 1,3-dicarbonyl compounds.

Visible Light-Mediated Photocatalytic Metal-Free Cross-Coupling Reaction of Alkenyl Carboxylic Acids with Diarylphosphine Oxides Leading to ß-Ketophosphine Oxides.

A new visible light-mediated photocatalytic decarboxylative oxyphosphorylation of cinnamic acids with diarylphosphine oxides is described. This reaction is performed under mild conditions to afford the corresponding ß-ketophosphine oxides.

Phosphinoyl Radical-Initiated 1,2-Bifunctional Thiocyanodiphenylphosphinoylation of Alkenes.

1,2-Bifuctional thiocyanodiphenylphosphinoylation of alkenes is established through the phosphinoyl radical addition followed by Cu-catalyzed thiocyanation. This one-pot reaction is applicable to a range of aromatic, aliphatic, and cyclic alkenes to afford thiocyanodiphenylphosphinoylated compounds in satisfactory yields.

"All-Inside" Arthroscopic Treatment of Tillaux-Chaput Fractures: Clinical Experience and Outcomes Analysis.

We investigated all-inside ankle arthroscopy for Tillaux-Chaput fractures. We retrospectively evaluated 19 patients (12 males [63.2%] and 7 [36.8%] females; 11 right [57.9%] and 8 left [42.1%] ankles) treated from May 2013 to January 2016. Their mean age was 28.1 (range 10 to 55) years. Sixteen (84.2%) had single Tillaux-Chaput fractures and 3 (15.8%) had combined proximal fibular fractures; 17 (89.5%) were diagnosed radiographically and 2 (10.5%) by computed tomography. Anterolateral and anteromedial ankle arthroscopy was used for closed reduction and internal fixation with 1 or 2 Herbert screws. Joint function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale. All 19 patients healed by first intention without nerve, vessel, or tendon injuries. The follow-up was 19.0 (range 12 to 25) months; fracture union was achieved by 23.5 (range 12 to 36) weeks. At the last follow-up, the 19 patients had no restrictions in ankle function and range of motion, with no ankle or walking pain. The AOFAS score changed from 52.8 to 91.7 points, with an excellent/good rate of 100%. These results suggest that anterolateral and anteromedial all-inside ankle arthroscopy is a precise and effective method for closed reduction and internal fixation of Tillaux-Chaput fractures.

Superficial Radial Nerve Transection Improves Sensory Outcomes in First Dorsal Metacarpal Artery Flaps.

BACKGROUND: This article reports the operative technique and clinical effect of repairing thumb pulp defects using a modified first dorsal metacarpal artery flap method. In this method, the dorsal branches of the radial and ulnar proper digital nerves of the index finger were preserved but the superficial branches of the radial nerve were transected. METHODS: Data obtained from 121 patients with thumb pulp defects who were admitted to the authors' hospital from June of 2011 to December of 2014 were retrospectively analyzed. Patients were divided into two groups based on whether the superficial branches of the radial nerve were transected. The dorsal branches of the radial and ulnar proper digital nerves of the index finger and the proper digital nerves in the wound were coapted using the end-to-end style. Static two-point discrimination, Semmes-Weinstein monofilament scores, pain, cold intolerance of the reconstructed finger, allachesthesia, and patient satisfaction were compared between the two groups. RESULTS: The authors observed significant differences in static two-point discrimination, Semmes-Weinstein monofilament flap score, pain of finger pulp, allachesthesia duration, and patient satisfaction (p < 0.05). The transection group presented slightly better discriminatory sensation in the flap and higher patient satisfaction. In addition, the duration of allachesthesia in the transection group was significantly shorter than that in the preservation group. CONCLUSION: In the repair of thumb pulp defects using a modified first dorsal metacarpal artery flap carrying the dorsal branches of the radial and ulnar proper digital nerves of the index finger, transecting the superficial branches of the radial nerve achieved better clinical outcome compared with preserving them. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Copper-catalyzed TEMPO oxidative cleavage of 1,3-diketones and ß-keto esters for the synthesis of 1,2-diketones and α-keto esters.

A copper-catalyzed efficient and practical method has been developed for the synthesis of 1,2-diketones and α-keto esters. TEMPO was used as a radical initiator and scavenger, oxidizing the cleavage of α-methylene of 1,3-diketones and ß-keto esters to form 1,2-diketones and α-keto esters. This method provided a general way for the formation of 1,2-dicarbonyl compounds.