RESUMO
The thread-link-cut (TLC) approach has previously shown promise as a novel method to synthesize molecular knots. The modular second-generation approach to small trefoil knots described herein involves electrostatic interactions between an electron-rich bis-macrocyclic host compound and electron-deficient guests in the threading step. The bis-macrocyclic host was synthesized in eight steps and 6.6% overall yield. Ammonium and pyridinium guests were synthesized in 4-5 steps. The TLC knot-forming sequence was carried out and produced a product with the expected molecular weight, but, unfortunately, further characterization did not produce conclusive results regarding the topology of the product.
RESUMO
Enteric fever (formerly typhoid fever) is a bacterial illness caused by fecal-oral transmission of Salmonella typhi or paratyphi. In early 2018, an outbreak of Salmonella typhi resistant to third-generation cephalosporins, ampicillin, ciprofloxacin, trimethroprim-sulfamethoxazole, and chloramphenicol was reported in Pakistan. This strain, termed "extensively resistant typhi," has infected more than 5000 patients in endemic areas of South Asia, as well as travelers to and from these areas, including 5 cases in the United States. We present the case of one such child who developed extensively resistant enteric fever during a recent visit to Pakistan and required broader antimicrobial treatment than typically required. Clinicians should be aware that incoming cases of enteric fever may be nonsusceptible to commonly recommended antibiotics and that extensively resistant typhi requires treatment with carbapenems such as meropenem or azithromycin.
Assuntos
Farmacorresistência Bacteriana Múltipla , Salmonella typhi , Febre Tifoide/diagnóstico , Febre Tifoide/tratamento farmacológico , Criança , Feminino , Humanos , Testes de Sensibilidade Microbiana , Paquistão/epidemiologia , Viagem , Febre Tifoide/epidemiologiaAssuntos
Blefaroptose/etiologia , Febre/etiologia , Transplante de Fígado , Linfoma Difuso de Grandes Células B/complicações , Transtornos Linfoproliferativos/complicações , Complicações Pós-Operatórias/diagnóstico , Biópsia , Encéfalo/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Lactente , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/patologia , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/patologiaRESUMO
Congenital hernias arising in the subcostal region are rare. We describe a case of a former preterm infant, born with congenitally fused right 11th and 12th ribs and a protuberant mass in the right subcostal region. This mass was associated with a small fascial defect and herniation of abdominal contents. At operation, the mass was determined to be a hernia with an incarcerated ovarian remnant and fallopian tube.