Electrochemical generation and utilization of alkoxy radicals.

This highlight summarises electrochemical approaches for the generation and utilization of alkoxy radicals, predominantly focusing on recent advances (2012-present). The application of electrochemically generated alkoxy radicals in a diverse range of transformations is described, including discussion on reaction mechanisms, scope and limitations, in addition to highlighting future challenges in this burgeoning area of sustainable synthesis.

Deconstructive Functionalization of Unstrained Cycloalkanols via Electrochemically Generated Aromatic Radical Cations.

Herein we report an electrochemical approach for the deconstructive functionalization of cycloalkanols, where various alcohols, carboxylic acids, and -heterocycles are employed as nucleophiles. The method has been demonstrated across a broad range of cycloalkanol substrates, including various ring sizes and substituents, to access useful remotely functionalized ketone products (36 examples). The method was demonstrated on a gram scale via single-pass continuous flow, which exhibited increased productivity in relation to the batch process.

Electrochemical Deconstructive Functionalization of Cycloalkanols via Alkoxy Radicals Enabled by Proton-Coupled Electron Transfer.

Herein, we report a new electrochemical method for alkoxy radical generation from alcohols using a proton-coupled electron transfer (PCET) approach, showcased via the deconstructive functionalization of cycloalkanols. The electrochemical method is applicable across a diverse array of substituted cycloalkanols, accessing a broad range of synthetically useful distally functionalized ketones. The orthogonal derivatization of the products has been demonstrated through chemoselective transformations, and the electrochemical process has been performed on a gram scale in continuous single-pass flow.

Clinical Presentations and Outcomes in Patients Presenting With Acute Cardiac Events and Right Bundle Branch Block.

We conducted a retrospective analysis of 50 974 patients admitted with acute cardiac events with and without right bundle branch block (RBBB) over 23 years. Compared to non-RBBB, patients with RBBB (n = 386; 0.8%) were 3 years older ( = .

Clinical Profile, Management, and Outcome in Patients With Out-of-Hospital Cardiac Arrest and ST Segment Elevation Myocardial Infarction: Insights From a 20-Year Registry.

Aim Of The Study: We studied the clinical profile, management, and outcomes of patients with out-of-hospital cardiac arrest (OHCA) with and without ST-elevation myocardial infarction (STEMI).

Methods: Retrospective analysis of the 20-year registry data (January 1991- June 2010) was conducted on patients with cardiac disease hospitalized at Hamad General Hospital and Qatar Heart Hospital, Doha, Qatar.

Results: A total of 987 patients with OHCA were admitted to the cardiology department during the study period; among them, 296 (30%) patients had STEMI.

Left Bundle Branch Block in Acute Cardiac Events: Insights From a 23-Year Registry.

Between 1991 and 2013, we evaluated the demographics, presentations, and final diagnosis of patients hospitalized with acute cardiac events and left bundle branch block (LBBB). Of 50 992 patients, 768 (1.5%) had LBBB.

Acute coronary syndrome and ethnicity: observations from the Middle East.

Aims: To evaluate the presentation and outcome of South Asian (SAP) to Middle Eastern Arabs (MEAP) patients presenting with acute coronary syndrome.

Methods: Data were collected retrospectively in Qatar between 1991 and 2010, and were analyzed according to patient ethnicity.

Results: Of 14,593 acute coronary syndrome patients, 49% were MEAP and 51% were SAP.

Mortality Trends in Patients Hospitalized with the Initial Acute Myocardial Infarction in a Middle Eastern Country over 20 Years.

We aimed to define the temporal trend in the initial Acute Myocardial Infarction (AMI) management and outcome during the last two decades in a Middle Eastern country. A total of 10,915 patients were admitted with initial AMI with mean age of 53 ± 11.8 years.

Association of risk factors with acute myocardial infarction in Middle Eastern countries: the INTERHEART Middle East study.

Background And Objectives: Mortality from cardiovascular disease in the Middle East (ME) is projected to increase substantially by 2020. There are no large studies on the impact of risk factors for acute myocardial infarction (AMI) in the region. This is a report on the association of nine risk factors with AMI in the ME.

Acute Myocardial Infarction in a Young Adult Male Associated with the use of Smokeless Tobacco (Sweka).

Dipping smokeless tobacco (ST) is used worldwide. We report a case of acute myocardial infarction in a young patient, who consumed smokeless tobacco (Sweka) for over one year. ST may be as harmful as smoking and carries adverse cardiac complications.

Prevalence of unrecognized diabetes mellitus in patients admitted with acute coronary syndrome.

We assessed the prevalence of unrecognized diabetes mellitus (DM) in patients with acute coronary syndrome (ACS) as determined by elevated glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and random plasma glucose (RPG) levels. This prospective study recruited 583 patients admitted with ACS without previous diagnosis of DM during 1-year period. Glycosylated hemoglobin was checked for most patients especially those with high values of FPG and or RPG.

Clinical presentation and cardiovascular risk profiles in patients with left main coronary artery disease in a middle eastern country.

We evaluated the prevalence and clinical profile of patients with left main coronary artery disease (LMCA) in Qatar between 2006 and 2010. Patients were divided into 2 groups: patients with LMCA and patients without LMCA but had severe 3-vessel disease (VeD) eligible for surgical revascularization. Among 7000 patients who underwent coronary angiography, 210 patients had significant LMCA and 200 patients with severe 3VeD were matched for age and sex.

Study of shift work and risk of coronary events.

Background: The effects of shift work on coronary heart diseases (CHD) are well described. Most of the studies on coronary events in shift workers are supportive of the hypothesis that they are at increased risk.

Objective: The objective of this study was to investigate the relation shift work has to risk of CHD in a cohort of men from different Asian races working in a fertilizer plant in the Middle East.

Does the circadian pattern for acute cardiac events presentation vary with fasting?

Background: Over one billion Muslims fast worldwide during the month of Ramadan. The impact of fasting on circadian presentation with acute cardiac events is unknown.

Aim: To determine if fasting has any effect on the circadian presentation of acute cardiac events.

Clinical and histologic studies of a Qatari family with myofibrillar myopathy.

The current study reports the first family with confirmed myofibrillar myopathy MFM in the Middle East and the third family worldwide. This study highlights the importance of considering MFM in young patients presenting with idiopathic cardiomyopathy, arrhythmia or atrioventricular block in the Gulf states. This is the first report that presented 2 different types of cardiomyopathy and 2 different indications of permanent pacemaker placement in the same generation of a family with MFM.

Acute myocardial infarction in a professional diver after jellyfish sting.

To our knowledge, acute myocardial infarction after jellyfish envenomation has not been reported previously. We describe a previously healthy 45-year-old male diver who had an acute inferior myocardial infarction with right ventricular involvement after a jellyfish sting on his left forearm while diving in the Gulf Sea. The patient had a normal controlled ascent after the incident.

Myocardial infarction with normal coronary angiography compared with severe coronary artery disease without myocardial infarction: the crucial role of smoking.

Background: Why do some patients suffer acute myocardial infarction (MI) despite angiographically normal coronary arteries (NL + MI) whereas others enjoy an acute MI-free life despite extensive three-vessel disease (3VD-MI)? The present study contrasts these two groups to identify some differences in the risk profile.

Methods: In 10,000 patients admitted to the cardiology service, a first MI was confirmed in 2356 patients, of whom 1609 underwent coronary angiography. In 77 patients with MI, coronary angiography was found to be entirely normal (NL + MI, 77/1609, 4.

Can rotational atherectomy cause thermal tissue damage? A study of the potential heating and thermal tissue effects of a rotational atherectomy device.

Purpose: Thermal tissue damage (TTD) is customarily associated with some lasers. The thermal potential of rotational atherectomy (RA) devices is unknown. We investigated the temperature profile and potential TTD as well as the value of fluid flushing of an RA device.

Fast rotating atherectomy catheter tip inhibits platelet aggregation and ATP release: a study using platelet-rich plasma.

The interaction of atherectomy devices with the arterial wall is the focus of many studies, but their effect on the surrounding blood is largely unknown. This is a detailed investigation on the effects of a rotational atherectomy device with a fast rotating tip on platelet structure and function. Platelet-rich plasma (PRP) was obtained from six volunteers, divided into 5 mL samples, and subjected to the atherectomy tip rotating at 20, 40, or 80 thousand rpm for 30 or 60 seconds.

Coronary angiography in Qatar: the first ten years.

Cardiac catheterization in Qatar was initiated in July 1982. In ten years, a total of 3900 procedures were performed at Hamad General Hospital. Computerized data registry has been maintained since 1982.

Percutaneous laser recanalisation of femoropopliteal occlusions using continuous wave Nd-YAG laser and sapphire contact probe delivery system.

A conventional continuous wave Nd-YAG medical laser system delivered by transparent sapphire tipped optical fibres was used for percutaneous recanalisation of 32 chronic femoropopliteal occlusions in 27 patients (19 men, eight women; median age 68 years, range 46-83 years). Twenty-four patients had severe intermittent claudication and three had critical ischaemia. The median occlusion length was 8 cm (range 3-35 cm) and lesions were not negotiable by guidewire.

Value of a radionuclide limb blood flow technique in the assessment of percutaneous balloon and dynamic angioplasty.

In a prospective study, a radionuclide technique was used to evaluate the limb blood flow (LBF) changes in 30 patients undergoing dynamic (n = 15) or balloon (n = 15) angioplasty for arterial occlusions or stenoses, respectively. The results were compared with Doppler Ankle Brachial Index (DABI) and treadmill exercise tests. Whilst LBF values (ml of blood flow per 100 ml of limb volume per min) were significantly lower in limbs with arterial occlusion than stenosis (4.

Does the Kensey catheter keep a coaxial position inside the arterial lumen? An in-vitro angioscopic study.

Angioscopy was used to evaluate the "self-centering" ability of three Kensey catheters (KC) with different flexibility: one 8Fr "peripheral" and two 5Fr "coronary" (I & II). Angioscopic observations were made inside arteries, 5-18 mm in diameter. There was a good correlation between flexibility and self-centering of the KC [r = 0.

Isotope limb blood flow measurement in patients undergoing peripheral laser angioplasty.

A technique of isotope limb blood flow (ILBF) measurement employing Technetium-labelled human albumin and a gamma camera, was used to assess limb perfusion in 19 patients undergoing percutaneous laser angioplasty, both before and one month after treatment. Twenty-three limbs with femoro-popliteal occlusions ranging in length from 3-35 cm (median 8 cm) were recanalized using an Nd-YAG laser and sapphire tipped optical fibre. Primary angiographic success was achieved in 19 lesions of which 6 re-occluded within the first month, and 13 remained patent with relief of symptoms.