Silver(I)-Catalyzed Dearomatization of Alkyne-Tethered Indoles: Divergent Synthesis of Spirocyclic Indolenines and Carbazoles.

A high-yielding, divergent approach to generate either spirocyclic indolenines or carbazoles from a common indole-tethered propargyl alcohol precursor is described, with mechanistic insight provided. Either product can be obtained upon treatment with different Ag(I) catalysts at rt. An unexpected hydration reaction to afford (±)-actinopolymorphol B is also reported.

Using negative pressure therapy for healing of a sternal wound.

Lisa Clubley and Lorraine Harper examine the treatment provided to a patient who had cardiac surgery and developed complications that resulted in the development of an extensive open sternal wound. The consultant surgeon responsible for the care made a decision to use negative pressure therapy (vacuum-assisted closure) despite such therapy for a wound of this nature being contraindicated in the manufacturer's clinical guidelines