High-Grade Mucinous Adenocarcinoma of the Appendix With Signet Features and Omental Metastasis.

Primary adenocarcinoma of the appendix is an uncommon malignancy of the gastrointestinal tract. The most common symptom is right lower abdominal pain, which could be indistinguishable from acute appendicitis. However, the clinical presentation is usually non-specific.

Myxedema Secondary to Levothyroxine Malabsorption in Newly Diagnosed Celiac Disease.

Celiac disease (CD) is an autoimmune disorder that predominantly affects the small intestine and is related to antibodies created against gluten when the substance is ingested. It is uncommon comorbidity in patients with Hashimoto's thyroiditis (HT). Myxedema is a severe form of hypothyroidism that is commonly related to new diagnoses, medication non-compliance, or malabsorption of thyroid supplementation that can have life-threatening associated conditions like heart failure and coma.

Boerhaave Syndrome: An Unexpected Complication of Diabetic Ketoacidosis.

Boerhaave syndrome (BS) is a rare gastrointestinal condition related to esophageal rupture that carries a high mortality rate without prompt medical attention. BS is commonly associated with repeated episodes of severe retching, straining, or vomiting. Diabetic ketoacidosis (DKA), a serious acute complication of diabetes, is characterized in part by laboratory findings of profound hyperglycemia and ketoacidosis.

Acute Renal Failure and Nephrotic Syndrome Secondary to Collapsing Glomerulopathy Associated With Hepatitis C.

Collapsing glomerulopathy (CG) is a rare variant of focal segmental glomerulosclerosis (FSGS) that commonly presents as nephrotic syndrome in patients. CG is almost always associated with human immunodeficiency virus (HIV) infection but is rarely from other infectious sources such as parvovirus, Epstein-Barr virus, cytomegalovirus, and SARS-CoV-2. CG has also been reported to be related to other etiologies such as genetic disorders, lupus, malignancy, and post-renal transplant but is exceedingly rare when related to hepatitis C virus (HCV).

Implementation and initial evaluation of falls risk reduction resources in a rural Native American Community.

Background: Although falls are common and can cause serious injury to older adults, many health care facilities do not have falls prevention resources available. Falls prevention resources can reduce injury and mortality rates. Using the Centers for Disease Control and Prevention's (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) model, a falls risk clinic was implemented in a rural Indian Health Service (IHS) facility.

Crystal structure of (E)-4,4'-(but-2-ene-1,4-di-yl)bis-(2-meth-oxy-phenol).

The title compound, C18H20O4, was synthesized via the ruthenium-catalyzed alkene methathesis dimerization of eugenol. The whole mol-ecule is generated by inversion symmetry; the center of inversion being located at the mid-point of the trans C=C bond. The phenol ring is inclined to the mean plane of the central C-C=C-C unit (r.

Crystal structure of 4,6-di-amino-2-(methyl-sulfan-yl)pyridine-3-carbo-nitrile.

The title pyrimidine derivative, C7H8N4S, is essentially planar, with a maximum deviation of 0.029 (2) Å from the mean plane of the non-H atoms. In the crystal, mol-ecules are linked by an inter-molecular bifurcated N-H⋯N hydrogen bond between the cyano N atom and the two amino groups, an N-H⋯N hydrogen bond between the two amino groups and a weak C-H⋯π inter-action, forming a three-dimensional network.

Crystal structure of N-[4-amino-5-cyano-6-(methyl-sulfan-yl)pyridin-2-yl]acetamide hemihydrate.

The title compound, C9H10N4OS·0.5H2O, crystallizes with two independent mol-ecules (A and B) in the asymmetric unit, together with a water mol-ecule of crystallization. The acetamide moiety, which has an extended conformation, is inclined to the pyridine ring by 7.

Crystal structure of N-[4-amino-5-cyano-6-(methyl-sulfan-yl)pyridin-2-yl]-2-chloro-acetamide.

In the title compound, C9H9ClN4OS, the dihedral angle between the acetamide moiety and the pyridine ring is 4.83 (12)°. The O=C-C-Cl torsion angle is 46.

9-Allyl-9H-fluoren-9-ol.

The asymmetric unit of the title compound, C16H14O, contains two independent mol-ecules differing in the orientations of the allyl groups; the corresponding O-C-C(H2)-C(H) torsion angles are -61.01 (13) and -177.43 (10)°.

Santal monohydrate, an isoflavone isolated from Wye-thia mollis.

THE TITLE COMPOUND [SYSTEMATIC NAME: 3-(3,4-di-hydroxy-phen-yl)-5-hy-droxy-7-meth-oxy-4H-chromen-4-one monohydrate], C16H12O6·H2O, is a monohydrate of a natural product santal isolated from Wye-thia mollis. In the santal mol-ecule, the dihedral angle between the benzo-quinone and di-hydroxy-phenyl fragments is 53.9 (1)° and an intra-molecular O-H⋯O hydrogen bond occurs.

Isotenulin.

Isotenulin, C17H22O5, is a sesquiterpene lactone isolated from sneezeweed Helenium amarum. It crystallizes with two independent mol-ecules in the asymmetric unit. In each mol-ecule, two five-membered rings (cyclo-pentenone and lactone) are trans-fused to the central seven-membered ring.

Tenulin 0.25-hydrate, a sesquiterpene lactone isolated from Helenium amarum.

The asymmetric unit of the title compound, C17H22O5·0.25H2O [systematic name: 2-hy-droxy-2,2a,6,9a-tetra-methyl-2a,4a,5,6,6a,9a,9b,9c-octa-hydro-2H-1,4-dioxadi-cyclo-pent[cd,f]azulene-3,9-dione 0.25-hydrate], a natural product isolated from Helenium amarum, contains two independent tenulin mol-ecules and half a water mol-ecule of crystallization situated on a twofold rotation axis.

The true identity of the triterpene component of Wyethia mollis, a lanosta-diene containing a tetrahydropyran E-ring.

The crystal structure of a triterpene component of Wyethia mollis has been obtained and compared with the previously reported structure of the compound. The compound in the crystal structure, lanosta-8,24-dien-3-one, 16,23-epoxy-(161beta, 23R), (1), is different from the previously reported compound, but has identical NMR and mass spectrometric data. The revised structure contains a tetrahydropyran E ring, a structural moiety rare in steroid triterpenes.