Probing the Matter: A Case of Rectal Foreign Body Insertion in a Patient With Intellectual Disability.

Rectal foreign body insertion presents a challenging clinical scenario, with increasing incidence, particularly among males. In both acute management and long-term care, particularly when associated with psychiatric illness or intellectual disability, careful consideration is required. We report a 23-year-old male with mild intellectual disability who presented with a retained handheld bidet shower inserted for sexual gratification.

Bi(OTf)-promoted cascade annulation of hydroxy-pyranones and unsaturated γ-ketoesters for the construction of polycyclic bridged pyrano-furopyranones.

An efficient protocol for constructing complex three dimensional polycyclic bridged chromano-furopyranones and pyrano-furopyranones (closely related to bioactive natural products) bismuth(III)-catalyzed cascade annulation of hydroxy-pyranones and unsaturated γ-ketoesters is presented. This process involves intermolecular Michael addition, intramolecular hemiketalization, lactonization, formation of one C-C bond and two C-O bonds, rings, and contiguous stereocenters.