Negative-Pressure Wound Therapy: A Novel Approach for Terminal Ileum Anastomosis Success.

BACKGROUND Terminal ileum (TI) anastomoses present challenges due to anatomical features and pressure from the ileocecal valve (ICV). The use of negative-pressure wound therapy (NPWT) is commonly used to treat chronic skin ulcers. Its use for temporary abdominal closure following anastomosis is controversial but has shown promise in patients with inflammatory or vascular disease.

Sonographically-navigated frozen shoulder release (S-FSR): A modified technique for sonographically-navigated, in-office hydrodilatation of adhesive capsulitis.

We describe a new technique for hydrodilatation of the frozen shoulder, which we coined 'Sonographically-Navigated Frozen Shoulder Release (S-FSR)' or 'Dr Gonzalez's technique.' Traditional treatments include a combination of conservative and surgical modalities, such as non-steroidal anti-inflammatories, physical therapy, and open capsular release. We describe a modification to hydrodilatation of the frozen shoulder.

Late gadolinium enhancement on cardiac MRI: A systematic review and meta-analysis of prognosis across cardiomyopathies.

Background: Late gadolinium enhancement (LGE) on cardiac MRI has been shown to predict adverse outcomes in a range of cardiac diseases. However, no study has systematically reviewed and analyzed the literature across all cardiac pathologies including rare diseases.

Methods: PubMed, EMBASE and Web of Science were searched for studies evaluating the relationship between LGE burden and cardiovascular outcomes.

Association of Adverse Clinical Outcomes With Peri-Infarct Ischemia Detected by Stress Cardiac Magnetic Imaging.

Background: Early invasive revascularization guided by moderate to severe ischemia did not improve outcomes over medical therapy alone, underlying the need to identify high-risk patients for a more effective invasive referral. CMR could determine the myocardial extent and matching locations of ischemia and infarction.

Objectives: This study sought to investigate if CMR peri-infarct ischemia is associated with adverse events incremental to known risk markers.

Gold(III) Auracycles Featuring C(sp)-Au-C(sp) Bonds: Synthesis and Mechanistic Insights into the Cycloauration Step.

The direct auration of arenes is a key step in numerous gold-catalyzed reactions. Although reported more than 100 years ago, understanding of its underlying mechanism has been hampered by the difficulties in the isolation of relevant intermediates given the propensity of gold(III) species to undergo reductive elimination. Here, we report the synthesis and isolation of a new family of intriguing zwitterionic [C(sp)^C(sp)]-auracyclopentanes, as well as of their alkyl-gold(III) precursors and demonstrate their value as mechanistic probes to study the C(sp)-Au bond-forming event.

Sex-Specific Stress Perfusion Cardiac Magnetic Resonance Imaging in Suspected Ischemic Heart Disease: Insights From SPINS Retrospective Registry.

Background: Cardiovascular disease (CVD) remains the leading cause of mortality in women, but current noninvasive cardiac imaging techniques have sex-specific limitations.

Objectives: In this study, the authors sought to investigate the effect of sex on the prognostic utility and downstream invasive revascularization and costs of stress perfusion cardiac magnetic resonance (CMR) for suspected CVD.

Methods: Sex-specific prognostic performance was evaluated in a 2,349-patient multicenter SPINS (Stress CMR Perfusion Imaging in the United States [SPINS] Study) Registry.

A Lewis Base Nucleofugality Parameter, , and Its Application in an Analysis of MIDA-Boronate Hydrolysis Kinetics.

The kinetics of quinuclidine displacement of BH from a wide range of Lewis base borane adducts have been measured. Parameterization of these rates has enabled the development of a nucleofugality scale (), shown to quantify and predict the leaving group ability of a range of other Lewis bases. Additivity observed across a number of series R'RX (X = P, N; R' = aryl, alkyl) has allowed the formulation of related substituent parameters (, ), providing a means of calculating values for a range of Lewis bases that extends far beyond those experimentally derived.

Titanium versus zirconia complete arch implant-supported fixed prostheses: A comparison of plaque accumulation.

Statement Of Problem: Complete arch implant-supported zirconia prostheses appear to have less plaque accumulation than titanium prostheses, but a comparison of the materials and the possible influence on the adjacent soft tissue is lacking.

Purpose: The purpose of this clinical study was to compare the plaque accumulation and soft-tissue inflammation of complete arch implant-supported fixed maxillary prostheses fabricated with either a titanium framework or monolithic zirconia.

Material And Methods: Twenty participants with a complete arch implant-supported fixed maxillary prosthesis were enrolled in the study.

Prognostic Value of Stress Cardiac Magnetic Resonance in Patients With Known Coronary Artery Disease.

Objectives: This study sought to determine whether stress cardiac magnetic resonance (CMR) provides clinically relevant risk reclassification in patients with known coronary artery disease (CAD) in a multicenter setting in the United States.

Background: Despite improvements in medical therapy and coronary revascularization, patients with previous CAD account for a disproportionately large portion of CV events and pose a challenge for noninvasive stress testing.

Methods: From the Stress Perfusion Imaging in the United States (SPINS) registry, we identified consecutive patients with documented CAD who were referred to stress CMR for evaluation of myocardial ischemia.

Boron Trifluoride-Mediated Cycloaddition of 3-Bromotetrazine and Silyl Enol Ethers: Synthesis of 3-Bromo-pyridazines.

Pyridazines are important scaffolds for medicinal chemistry or crop protection agents, yet the selective preparation of 3-bromo-pyridazines with high regiocontrol remains difficult. We achieved the Lewis acid-mediated inverse electron demand Diels-Alder reaction between 3-monosubstituted -tetrazine and silyl enol ethers and obtained functionalized pyridazines. In the case of 1-monosubstituted silyl enol ethers, exclusive regioselectivity was observed.

Solitary Fibrous Tumor in the Perianal Region: Report of Two Cases With an Atypical Location.

A solitary fibrous tumor (SFT) is a mesenchymal neoplasm of spindle cells, initially described in the pleura. The World Health Organization (WHO) classifies the solitary fibrous tumor as a neoplasm with intermediate biological potential. Diagnostic images are essential for the diagnostic and therapeutic approach in this entity.

Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry.

Aims: Non-invasive assessment and risk stratification of coronary artery disease in patients with large body habitus is challenging. We aim to examine whether body mass index (BMI) modifies the prognostic value and diagnostic utility of stress cardiac magnetic resonance imaging (CMR) in a multicentre registry.

Methods And Results: The SPINS Registry enrolled consecutive intermediate-risk patients who presented with a clinical indication for stress CMR in the USA between 2008 and 2013.

Strengthening the Bolivian pharmacovigilance system: New surveillance strategies to improve care for Chagas disease and tuberculosis.

Chagas disease (CD) and tuberculosis (TB) are important health problems in Bolivia. Current treatments for both infections require a long period of time, and adverse drug reactions (ADRs) are frequent. This study aims to strengthen the Bolivian pharmacovigilance system, focusing on CD and TB.

Imaging of Clinically Unrecognized Myocardial Fibrosis in Patients With Suspected Coronary Artery Disease.

Background: Stress cardiac magnetic resonance (CMR) provides accurate assessment of both myocardial infarction (MI) and ischemia.

Objectives: This study aimed to evaluate the incremental prognostic value of unrecognized myocardial infarction (UMI), detected during assessment of coronary artery disease (CAD) by stress CMR, beyond cardiac function and ischemia.

Methods: In the multicenter SPINS (Stress CMR Perfusion Imaging in the United States) study, 2,349 consecutive patients (63 ± 11 years of age, 53% were male) with suspected CAD were assessed by stress CMR and followed over a median of 5.

Phosphorescent κ -(N^C^C)-Gold(III) Complexes: Synthesis, Photophysics, Computational Studies and Application to Solution-Processable OLEDs.

Efficient OLED devices have been fabricated using organometallic complexes of platinum group metals. Still, the high material cost and low stability represent central challenges for their application in commercial display technologies. Based on its innate stability, gold(III) complexes are emerging as promising candidates for high-performance OLEDs.

Coronary Computed Tomography Angiography Demonstrates a High Burden of Coronary Artery Disease Despite Low-Risk Nuclear Studies in Pre-Liver Transplant Evaluation.

We investigated the presence and severity of coronary artery disease (CAD) in orthotopic liver transplantation (OLT) candidates using coronary artery calcium score (CACS) and coronary computed tomography angiography (CCTA) as compared with the prevalence of normal and abnormal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). A total of 140 prospective OLT candidates without known CAD underwent coronary artery calcium (CAC) scans with (n = 77) or without CCTA and coronary computed tomography angiography-derived fractional flow reserve (FFR ; n = 57) using a dual-source computed tomography (CT) and were followed for 2.6 ± 1.

Prognostic Value of Stress CMR Perfusion Imaging in Patients With Reduced Left Ventricular Function.

Objectives: The aim of this study was to investigate the prognostic value of stress cardiac magnetic resonance imaging (CMR) in patients with reduced left ventricular (LV) systolic function.

Background: Patients with ischemic cardiomyopathy are at risk from both myocardial ischemia and heart failure. Invasive testing is often used as the first-line investigation, and there is limited evidence as to whether stress testing can effectively provide risk stratification.

Evaluation of Stress Cardiac Magnetic Resonance Imaging in Risk Reclassification of Patients With Suspected Coronary Artery Disease.

Importance: The role of stress cardiac magnetic resonance (CMR) imaging in clinical decision-making by reclassification of risk across American College of Cardiology/American Heart Association guideline-recommended categories has not been established.

Objective: To examine the utility of stress CMR imaging for risk reclassification in patients without a history of coronary artery disease (CAD) who presented with suspected myocardial ischemia.

Design, Setting, And Participants: A retrospective, multicenter cohort study with median follow-up of 5.

[C^N]-Alkenyl Gold(III) Complexes by Proximal Ring-Opening of (2-Pyridyl)alkylidenecyclopropanes: Mechanistic Insights.

Pyridine-substituted alkylidenecyclopropanes (Py-ACPs) react with gold(III) salts under mild reaction conditions through an unprecedented, proximal ring-opening pathway, to generate highly appealing, catalytically active pyridine alkenyl [C^N]-gold(III) species. Mechanistic studies reveal that the activation of the C-C bond of the ACP takes place through an unusual concerted, σ-bond metathesis type-process.

Mechanistic Insights into C(sp )-C(sp)N Reductive Elimination from Gold(III) Cyanide Complexes.

A new family of phosphine-ligated dicyanoarylgold(III) complexes has been prepared and their reactivity towards reductive elimination has been studied in detail. Both, a highly positive entropy of activation and a primary C KIE suggest a late concerted transition state while Hammett analysis and DFT calculations indicate that the process is asynchronous. As a result, a distinct mechanism involving an asynchronous concerted reductive elimination for the overall C(sp )-C(sp)N bond forming reaction is characterized herein, for the first time, complementing previous studies reported for C(sp )-C(sp ), C(sp )-C(sp ), and C(sp )-C(sp ) bond formation processes taking place on gold(III) species.

Stability of bubble-like fluxons in disk-shaped Josephson junctions in the presence of a coaxial dipole current.

We investigate analytically and numerically the stability of bubble-like fluxons in disk-shaped heterogeneous Josephson junctions. Using ring solitons as a model of bubble fluxons in the two-dimensional sine-Gordon equation, we show that the insertion of coaxial dipole currents prevents their collapse. We characterize the onset of instability by introducing a single parameter that couples the radius of the bubble fluxon with the properties of the injected current.

Cost-Effectiveness Analysis of Stress Cardiovascular Magnetic Resonance Imaging for Stable Chest Pain Syndromes.

Objectives: The aim of this study was to compare, using results from the multicenter SPINS (Stress CMR Perfusion Imaging in the United States) study, the incremental cost-effectiveness of a stress cardiovascular magnetic resonance (CMR)-first strategy against 4 other clinical strategies for patients with stable symptoms suspicious for myocardial ischemia: 1) immediate x-ray coronary angiography (XCA) with selective fractional flow reserve for all patients; 2) single-photon emission computed tomography; 3) coronary computed tomographic angiography with selective computed tomographic fractional flow reserve; and 4) no imaging.

Background: Stress CMR perfusion imaging has established excellent diagnostic utility and prognostic value in coronary artery disease (CAD), but its cost-effectiveness in current clinical practice has not been well studied in the United States.

Methods: A decision analytic model was developed to project health care costs and lifetime quality-adjusted life years (QALYs) for symptomatic patients at presentation with a 32.

Cardiac Magnetic Resonance Stress Perfusion Imaging for Evaluation of Patients With Chest Pain.

Background: Stress cardiac magnetic resonance imaging (CMR) has demonstrated excellent diagnostic and prognostic value in single-center studies.

Objectives: This study sought to investigate the prognostic value of stress CMR and downstream costs from subsequent cardiac testing in a retrospective multicenter study in the United States.

Methods: In this retrospective study, consecutive patients from 13 centers across 11 states who presented with a chest pain syndrome and were referred for stress CMR were followed for a target period of 4 years.

The Association Between Occlusal Status and the Soft and Hard Tissue Conditions Around Single-Unit Dental Implants.

The occlusal status of single-unit dental implants were evaluated using traditional and computerized methods. The type of occlusal contact in maximum intercuspation and the presence of occlusal contacts on the implant during eccentric movements were recorded. A digital sensor was used for computerized analysis of occlusion.