Access to Functionalized Quaternary Stereocenters via the Copper-Catalyzed Conjugate Addition of Monoorganozinc Bromide Reagents Enabled by N, N-Dimethylacetamide.

Monoorganozinc reagents, readily obtained from alkyl bromides, display excellent reactivity with β,β-disubstituted enones and TMSCl in the presence of Cu(I) and Cu(II) salts to synthesize a variety of cyclic functionalized β-quaternary ketones in 38-99% yields and 9:1-20:1 diastereoselectivities. The conjugate addition features a pronounced improvement in DMA using monoorganozinc bromide reagents. A simple one-pot protocol that harnesses in situ generated monoorganozinc reagents delivers comparable product yields.

Developing an indigenous surgical workforce for Australasia.

Background: Progress has been made in Australia and New Zealand to increase the numbers of indigenous students (Aboriginal, Torres Strait Islander and Maori) entering primary medical qualification courses. In New Zealand, up to 20 Maori are graduating annually, with similar numbers possible in Australia, creating a potential opportunity to develop an indigenous surgical workforce.

Methods: A literature review identified factors utilized by medical schools to attract indigenous students into medical careers and the interventions necessary to ensure successful graduation.

Consensus statement from the Health of the Health Professional Conference, November 2011.

This article presents a consensus statement that arose from the views of participants that attended the multidisciplinary conference "The Health of the Health Professional", in Auckland in November 2011. A healthy workforce is the key to improving the health of all New Zealanders. Yet health practitioners' health is of concern, and despite the evidence of real problems little has been done to constructively and systematically address these issues.

Validity of two selected-item short forms of the WAIS-III in an intellectually deficient sample.

Various short forms of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III; D. Wechsler, 1997) have been investigated, but limited information is available regarding the usefulness of any WAIS-III abbreviation with intellectually deficient individuals. Our study compared the validities of two WAIS-III selected-item short forms in a sample of 59 individuals with full scale IQs (FSIQs) of 79 or lower.

Effect of implanted insulin pumps on fluorescein transcapillary escape time in type 1 diabetes mellitus.

Objective: To determine whether significant increases in fluorescein transcapillary escape time (FTET) would occur after treatment of patients with type 1 diabetes with insulin delivered intraperitoneally by a surgically implanted pump.

Methods: Nine patients with type 1 diabetes who were otherwise healthy and had received surgically implanted insulin pumps on a study protocol were recruited to have three measurements of FTET and glycosylated hemoglobin during an 18-month period. Serum fluorescein-albumin binding was measured at the time of the final test.

Psychological stress impairs early wound repair following surgery.

Objective: Laboratory studies have demonstrated that psychological stress is associated with slower healing of small superficial wounds. The application of this finding to the clinical environment has not yet been undertaken. In order to do this, we investigated the relationship between psychological stress and wound repair in patients following routine surgery.

Age-related changes in adenylyl cyclase activity in rat aorta membranes.

Blood vessels from aged animals and humans have impaired relaxation and cAMP production to beta-adrenergic stimulation. Direct activators of adenylyl cyclase (AC) such as forskolin are not affected. We hypothesized that analogous findings would occur in membrane preparations.

Health service reform: the perceptions of medical specialists in Australia (New South Wales), the United Kingdom and New Zealand.

Objective: To examine the effect of recent healthcare service changes (including significant resource constraint and a greater role for the non-medical manager) in the United Kingdom, Australia and New Zealand on medical specialists' perceptions of their healthcare organisation goals and service delivery, and their enthusiasm for their work.

Design: Postal questionnaire survey, answered anonymously.

Participants And Setting: Medical specialists employed either part- or full-time in two United Kingdom National Health Service Trusts (one acute, one mental health/community service), an Australian Area Health Service and a New Zealand Crown Health Enterprise in 1995.

Plasma fluorescein binding and transcapillary fluorescein escape rate in renal failure associated with diabetes.

Microvascular damage, often resulting in renal failure, is a common complication of diabetes. Transcapillary fluorescein escape rate (TCFER) as monitored by intravital microscopy has been used as an indicator of the extent of capillary damage in diabetes and to assess improvement in microvascular function after combined kidney-pancreas transplant. However, fluorescein anion binds to plasma albumin, and albumin-ligand binding may be altered in the presence of renal disease.

Sources of stress and satisfaction in crown health enterprise senior medical staff.

Aim: To report the sources of stress and satisfaction in the specialist workforce of three crown health enterprises (CHEs).

Method: Ninety eight specialists in Northland Health, Waitemata Health and Southern Health completed a questionnaire rating 39 factors for causing stress and satisfaction in their daily work.

Results: The commonest sources of stress for specialists were keeping up to date, carrying a heavy clinical workload and time pressure generally.

Antibiotic protocol for appendicectomy--costs and benefits of single dose therapy.

Aims: To examine possible savings from the introduction of an antibiotic protocol for one surgical procedure and to define antibiotic charting techniques.

Methods: An antibiotic policy for patients undergoing an appendicectomy was instituted in the surgical unit at North Shore Hospital to examine possible savings and to define antibiotic charting techniques. Depending on the macroscopic findings at surgery a third generation cephalosporin was used either as a single dose intraoperatively or for multiple doses postoperatively.

Effect of low-level and intermittent minocycline therapy on the growth of Mycobacterium leprae in mice.

We evaluated the minimal concentrations of minocycline in the diet and in serum required to inhibit the growth of seven Mycobacterium leprae isolates in mice. Minocycline concentrations of 0.01 and 0.

Prescription drug therapy in the podiatric outpatient population: interactions and precautions.

A survey of 2,000 outpatients at the clinic of the Dr. William M. Scholl College of Podiatric Medicine was conducted analyzing both medications reported by the patients at the time of treatment and drugs by the attending podiatrist.

Comparison of the pyrimidine nucleoside phosphorylase activity in human tumors and normal tissues.

The novel fluoropyrimidine, 5'-deoxy-5-fluorouridine (5'-dFUDR) has strong tumor-inhibiting effect without severe cytotoxic effects on the normal cells. This pro-drug is metabolized by the enzyme pyrimidine nucleoside phosphorylase (PN'ase) to the active form 5-fluorouracil. Comparative determinations of pyrimidine nucleoside phosphorylase activity in tissue extracts revealed a significantly higher activity in the human gastrointestinal cancer tissues (6.

Age and sex differences in right colon cancer.

In a prospective study of 402 colorectal cancer patients, 133 patients (46 men and 87 women) presented with right colon cancer. There was no significant difference between men and women in right colon cancer incidence. Common presenting features were abdominal pain, weight loss, and anemia.

Colorectal cancer in Auckland 1981-1982: patients with liver metastases.

In a population-based study of 402 cases of colorectal cancer in Auckland, 72 patients (18%) demonstrated liver metastases either at presentation or at initial surgery. The findings of pre-operative weight loss, hepatomegaly and elevated alkaline phosphatase were significantly associated with heptic metastases. Individually these factors were insensitive indicators of the presence of liver metastases.