Ramsay Hunt syndrome and concurrent varicella-zoster virus meningitis in Denmark: A nationwide cohort study.

Ramsay Hunt syndrome (RHS) is a manifestation of reactivated varicella-zoster virus (VZV) from the geniculate ganglion. Data on clinical features and outcomes of patients with RHS and concurrent VZV meningitis (henceforth RHS meningitis) are limited. Thus, we conducted a nationwide population-based cohort study of all adults hospitalized for RHS meningitis at the departments of infectious diseases in Denmark from 2015 to 2020. Patients with VZV meningitis without cranial nerve palsies were included for comparison. In total, 37 patients with RHS meningitis (mean annual incidence: 1.6/1 000 000 adults) and 162 with VZV meningitis without cranial nerve palsies were included. In RHS meningitis, the median age was 52 years (interquartile range: 35-64), and in addition to peripheral facial nerve palsy (100%), dizziness (46%), and hearing loss (35%) were common symptoms. The triad of headache, neck stiffness, and photophobia/hyperacusis was less common in RHS meningitis than in VZV meningitis without cranial nerve palsies (0/27 [0%] vs. 24/143 [17%]; p = 0.02). At 30 days after discharge, 18/36 (50%) patients with RHS meningitis had persistent peripheral facial nerve palsy, with no statistically significant difference between those treated with and without adjuvant glucocorticoids (6/16 [38%] vs. 12/20 [60%]; p = 0.18). Additional sequelae of RHS meningitis included dizziness (29%), neuralgia (14%), tinnitus/hyperacusis (11%), hearing loss (9%), headache (9%), fatigue (6%), and concentration difficulties (3%). In conclusion, clinical features and outcomes of RHS meningitis were primarily related to cranial neuropathies.

Group A Streptococcus Meningitis in Adults, Denmark.

We report a 21-fold increase in group A Streptococcus meningitis in adults in Denmark during October 13, 2022-April 12, 2023, concurrent with an outbreak of invasive streptococcal disease. We describe clinical characteristics of the outbreak cases and prognosis for patients in comparison to those for previous sporadic cases.

Influence of 3d Transition Metal Doping on Lithium Stabilized Na-ß″-Alumina Solid Electrolytes.

Na-ß″-alumina is the commercially most successful solid electrolyte due to its application in ZEBRA and NAS® batteries. In this work, Li-stabilized Na-ß″-alumina electrolytes were doped with 3d transition metal oxides, namely TiO2, Mn3O4, and NiO, in order to improve their ionic conductivity and fracture strength. Due to XRD and EDX measurements, it was concluded that Mn- and Ni-ions are incorporated into the crystal lattice of Na-ß″-alumina. In contrast, TiO2 doping results in the formation of secondary phases that enable liquid-assisted sintering at temperatures as low as 1500 °C. All dopants increased the characteristic fracture strength of the electrolytes; 1.5 wt% of NiO doping proved to be most efficient and led to a maximal characteristic fracture strength of 296 MPa. Regarding the ionic conductivity, TiO2 doping showed the uppermost value of up to 0.30 S cm-1 at 300 °C. In contrast to the other dopants, TiO2 doping lowered the sintering temperature needed to obtain a dense, stable, and highly conductive Na-ß″-alumina electrolyte suitable for applications in Na based batteries.

First total synthesis of the biscarbazole alkaloid oxydimurrayafoline.

We report the first total synthesis of oxydimurrayafoline via nucleophilic substitution at the benzylic position at C-3 of the carbazole framework.

ICD therapy in children and young adults: low incidence of inappropriate shock delivery.

INTRODUCTION: Implantable cardioverter defibrillator (ICD) therapy of life-threatening arrhythmias in pediatric patients is feasible; however, recent studies report a high incidence of inappropriate shock deliveries. METHODS: The data of all recipients of an ICD at the Charité, Department of Pediatric Cardiology, between January 2001 and November 2007 were retrospectively analyzed regarding underlying cardiac disorders, arrhythmias, medication, ablation procedures, leads and devices, programming, and ICD therapies. RESULTS: A total of 33 patients underwent ICD implantation, with a median age of 16.5 years (range 8-36 years) and a mean weight of 61 +/- 20.9 kg. Underlying cardiac disorders were electrical heart disease (27%), cardiomyopathy (30%), congenital heart disease (33%), and others (9%). Eighty-five percent received antiarrhythmic drugs, and 12 ablation procedures were performed in nine patients (27%). The devices were programmed individually according to the underlying diseases and arrhythmias. During follow-up, a total of 63 shock therapies were delivered in 11 patients, while a majority of 34 shocks occurred in one patient (no therapies in 22 of 33 patients). Only two such therapies were inappropriate, both delivered for atrial flutter. CONCLUSIONS: In children and young adults receiving ICD therapy, the combination of strategies to prevent ventricular arrhythmias using specific drug therapy, ablation procedures, and individual programming with improved devices and leads causes a low incidence of inappropriate shock delivery.

First total synthesis of the 7-oxygenated carbazole alkaloids clauszoline-K, 3-formyl-7-hydroxycarbazole, clausine M, clausine N and the anti-HIV active siamenol using a highly efficient palladium-catalyzed approach.

Using a convergent palladium-catalyzed construction of the carbazole framework as the key step we have achieved a short synthesis of the 7-oxygenated carbazole alkaloids clauszoline-K, 3-formyl-7-hydroxycarbazole, clausine C (clauszoline-L), clausine M, clausine N and the anti-HIV active siamenol.

First total synthesis of the biologically active 2,7-dioxygenated tricyclic carbazole alkaloids 7-methoxy-O-methylmukonal, clausine H (clauszoline-C), clausine K (clauszoline-J) and clausine O.

Using the iron-mediated arylamine cyclization as the key step we have achieved a short and highly efficient access to the biologically active 2,7-dioxygenated tricyclic carbazole alkaloids 7-methoxy-O-methylmukonal, clausine H (clauszoline-C), clausine K (clauszoline-J) and clausine O.