Green Synthesis of Morpholines via Selective Monoalkylation of Amines.

Morpholines are common heterocycles in pharmaceutical and agricultural products, yet methods to synthesize them from 1,2-amino alcohols are inefficient. We report the simple, high yielding, one or two-step, redox neutral protocol using inexpensive reagents (ethylene sulfate and BuOK) for the conversion of 1,2-amino alcohols to morpholines. Key to this methodology is the identification of general conditions that allow for the clean isolation of monoalkylation products derived from a simple S2 reaction between an amine and ethylene sulfate.

Autoinflammatory Diseases: A Review.

Autoinflammatory disease (AID) is a vast spectrum of disorders characterized by recurrent attacks of sterile inflammation. Since the first cloning of the familial Mediterranean fever gene in 1997, there has been a rapid rate of discovery of new AIDs. As of 2022, there have been 485 inborn errors of immunity documented by the International Union of Immunological Societies, for which many display aspects of autoinflammation.

Case report: Novel variants in RELA associated with familial Behcet's-like disease.

RELA haploinsufficiency is a recently described autoinflammatory condition presenting with intermittent fevers and mucocutaneous ulcerations. The RELA gene encodes the p65 protein, one of five NF-κB family transcription factors. As RELA is an essential regulator of mucosal homeostasis, haploinsufficiency leads to decreased NF-κB signaling which promotes TNF-driven mucosal apoptosis with impaired epithelial recovery.

Pyrroloiminoquinone Alkaloids: Total Synthesis of Makaluvamines A and K.

Herein, an efficient, scalable, and concise approach to an advanced pyrroloiminoquinone synthetic intermediate () by way of a Larock indole synthesis is reported. The synthetic utility of this intermediate is demonstrated by its ready conversion to makaluvamines A () and K ().

Protective Equipment Preparedness and Accessibility: A Survey of Medical Trainees.

Introduction: After being removed from patient care due to equipment shortages, medical students and new residents around the United States are returning to clinical medicine/acute care settings as the SARS-CoV-2 (COVID-19) pandemic continues. We hypothesize that trainees returned with increased preparedness and had better access to and knowledge of personal protective equipment (PPE).

Methods: Anonymous online surveys were distributed via snowball sampling to medical students and residents performing clinical duties in the United States.

Case Report: It's a Small Whirl Afterall.

Unlabelled: Recognition of the whirl sign on computed tomography (CT) imaging can improve patient outcomes in those presenting with small bowel obstruction (SBO). In the case highlighted in this report, a 40-year-old woman with a remote history of gastric bypass presented to the emergency department (ED) with four hours of abdominal pain and vomiting. Findings on the initial CT of the abdomen and pelvis were suggestive of SBO with a whirl sign pattern.

Easily accessible non-aromatic heterocycles with handles: 4-bromo-2,3-dihydrofurans from 1,2-dibromohomoallylic alcohols.

The first general preparation of 4-bromo-2,3-dihydrofurans is reported. These non-aromatic heterocycles containing a useful coupling handle are accessed Cu-catalyzed intramolecular cyclization of 1,2-dibromohomoallylic alcohols, which are themselves available in just two steps from aromatic and aliphatic aldehydes and ketones. Molecular dynamics simulations using the simple substrates and key geometric parameters provide a rationale for the selectivities observed.

Complete Hypokalemic Quadriparesis as a First Presentation of Sjögren Syndrome.

Rationale: We hope to increase awareness that hypokalemic paralysis may be the first presentation of Sjögren syndrome, for which potassium-sparing diuretics can be an effective adjunct to potassium replenishment.

Presenting Concerns: A 73-year-old female presented to a peripheral hospital with quadriparesis and a critically low serum potassium of 1.6 mmol/L with U waves on the electrocardiogram (ECG).