Reaction of unsymmetrical α-bromo-1,3-diketones with -substituted thioureas: regioselective access to 2-(-arylamino)-5-acyl-4-methylthiazoles and/or rearranged 2-(-acylimino)-3--aryl-4-methylthiazoles.

The present study reports some fascinating results of Hantzsch's [3 + 2] cyclic condensation of α-bromo-1,3-diketones, a tri-electrophilic synthon generated by bromination of 1,3-diketones using the mild brominating reagent NBS with trinucleophilic -substituted thioureas. Interestingly, out of a total of 20 combinations, 10 resulted in the exclusive formation of the desired 2-(-arylamino)-5-acyl-4-methylthiazoles regioselectively, seven led to the formation of unexpected 2-(-acylimino)-3--aryl-4-methylthiazoles through an interesting C-N acyl migration, and three furnished a mixture consisting of both products. The regioselectivity pattern of the two products may be attributed to a greater electrophilicity of the carbonyl carbon of the acetyl group than that of the acyl group towards both nitrogens of thiourea.

Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis: Macules, Papules, and Bullae.

Objective: The objective of this discussion paper is to illuminate the importance of early identification and treatment of Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). SJS/TEN may occur as quickly as 4 days, more commonly 4 to 8 weeks after starting a new medication and early identification is essential.

Methods: A review of literature revealed there is a lack of diagnostic awareness related to the clinical presentation and diverse populations at risk for this devastating syndrome.

Identifying adaptations for a mindfulness program for Spanish-speaking mothers of children with chronic conditions or disabilities.

Mothers of children with chronic conditions or disabilities have benefited from mindfulness programs, yet culturally relevant mindfulness programs for Spanish-speaking mothers are lacking. We aimed to explore how this population experienced a peer-led mindfulness program to inform adaptations. Sixteen mothers attended a 6-week program and completed semi-structured interviews.

Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy.

Introduction: Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes.

Methods: This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH.

Effects of the lockdown due to the COVID-19 pandemic on alcohol consumption in patients under treatment in an alcohol relapse prevention programme.

During the COVID-19 pandemic, several exceptional measures were put in place in order to avoid virus propagation, such as lockdown and the discontinuation of usual health care assistance services. It was considered that these changes might be associated with an increase in alcohol consumption and a higher risk of relapse for patients under treatment. The aim of this study was to assess changes in alcohol consumption during the lockdown period (between March and May, 2020) in patients following treatment under the Alcohol Use Disorders Programme at the "Hospital 12 de Octubre" in Madrid.

A practical guide to vitiligo differential diagnoses in primary care.

Primary care providers often encounter different types of pigmentary disorders such as vitiligo. This article arms the provider with the most common vitiligo differential diagnoses, with key findings and tips to identify specific hypopigmentary diseases. Readers will be better-prepared to provide safe and effective care and recommend referrals to appropriate specialties.

Alveolar rhabdomyosarcoma metastatic to the brain.

Alveolar rhabdomyosarcoma (ARMS) has a predilection for the peripheral extremities, and brain metastases are rare, with only a few cases reported after the initial diagnosis. We present a 22-year-old male patient with a right orbital-ethmoidal ARMS who presented with a recurrence to the brain 1 year after the initial diagnosis. He was referred to our institution due to acute neurological deterioration.

Pancreatic hamartoma in a premature Trisomy 18 female.

Pancreatic hamartomas are extremely rare tumors in adults and even more so in children. They are lesions characterized by acinar, islet and ductal components found in varying proportions and in a disorganized pattern. We report a case of a premature female with trisomy 18 diagnosed by amniocentesis.

Angiosarcoma of the Pelvis in a 13-Year-Old Girl.

Angiosarcomas are highly aggressive malignancies of vascular origin and are very rarely found in children. We report a case of a 13-year-old girl with a history of abdominal pain and increased abdominal girth. Radiologic imaging showed significant ascites and large pelvic masses involving bilateral adnexa with abdominal spread.

Stress in parents of very low birth weight preterm infants hospitalized in neonatal intensive care units. A multicenter study.

Introduction: The birth of a premature baby is a stressful event for parents. The objective of this study was to determine early stress in parents of very low birth weight infants (VLBWIs) hospitalized in 12 neonatal intensive care units from a South American Neonatal Network, to identify associated factors, and to compare the level of parental stress in public versus private healthcare facilities.

Population And Methods: Cross-sectional study in mothers/fathers of VLBWIs (500 to 1500 g).

Comparative study of different methods for the preparation of tetraamidato- and tetracarboxylatodiruthenium compounds. Structural and magnetic characterization.

Solvothermal and microwave assisted synthesis were used as green and very useful alternative methods to obtain new chloridotetraamidatodiruthenium compounds, [Ru(2)Cl(μ-NHOCR)(4)](n) [R = Me-o-C(6)H(4) (1), Me-m-C(6)H(4) (2), Me-p-C(6)H(4) (3)]. The analogous tetracarboxylato complexes [Ru(2)Cl(μ-O(2)CR)(4)](n) [R = Me-o-C(6)H(4) (4), Me-m-C(6)H(4) (5), Me-p-C(6)H(4) (6)] have also been obtained. These synthetic methods allow the use of greener solvents like water or ethanol.

Early association of low-grade albuminuria and allograft dysfunction predicts renal transplant outcomes.

Background: Data on the combined associations of albuminuria and estimated glomerular filtration rate (eGFR) with renal transplant outcomes are limited. Our objective was to explore how renal transplant outcomes could be predicted by a combined variable of early low-grade albuminuria and allograft dysfunction.

Methods: We studied a cohort of adult deceased-donor kidney transplant recipients who were subdivided into four groups according to median albuminuria (100 mg/day, interquartile range, 0-470 mg/day) and median eGFR (60 mL/min/1.

Renin-angiotensin system blockade and kidney transplantation: a longitudinal cohort study.

Background: The beneficial effect of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) in kidney transplant recipients on modern immunosuppression is not yet well established. Our objective was to investigate the impact of the use of ACEI/ARB on patient and graft survival in a cohort of kidney transplant recipients.

Methods: A total of 990 patients, who received a single deceased donor kidney at our institution between 1996 and 2005, were included in this longitudinal cohort study.

Metabolic syndrome, insulin resistance, and chronic allograft dysfunction.

Metabolic syndrome (MS) is a cluster of cardiovascular (CV) risk factors (hypertension, dyslipidemia, obesity, and glucose homeostasis alterations), and insulin resistance (IR) is suggested to be a common pathogenic background. In the general population, MS and IR have been proven to be risk factors for diabetes, CV disease, and chronic kidney disease. In the renal transplant setting, few studies have analyzed the relevance of MS and IR.

Hyperinsulinemia and hyperfiltration in renal transplantation.

Background: Insulin-resistance hyperinsulinemia is a novel risk factor for renal disease in the general population. Glomerular hyperfiltration has been proposed as an early consequence of hyperinsulinemia.

Methods: In this multicenter cohort study, we analyzed 202 patients without diabetes before or after renal transplantation during the first posttransplant year.

Impact of cold ischemia time on renal allograft outcome using kidneys from young donors.

Prolonged cold ischemia time (CIT) is associated with delayed graft function and worse kidney transplant (KT) outcome, but the effect of CIT on long-term allograft survival in KT from younger donors has not been well established. We investigated the predictive value of CIT exposure on long-term death-censored graft loss in 829 KT recipients from younger donors (<50 years) that were performed in our center between 1991 and 2005. Overall death-censored graft failure rate was significantly higher in CIT>or=19 h group versus CIT<19 h group (26 vs.

Prediabetes in patients receiving tacrolimus in the first year after kidney transplantation: a prospective and multicenter study.

Background: Tacrolimus-based immunosuppression, the most widely used regimen in kidney transplantation, increases the risk of new onset diabetes after transplantation (NODAT). However, the prevalence, evolution and risk factors of different prediabetic alterations: impaired fasting glucose, impaired glucose tolerance, and provisional diabetes, have not been established.

Methods: In this multicenter and prospective study we evaluated 154 nondiabetic kidney transplant recipients receiving tacrolimus, mycophenolate mofetil and low dose steroids.

Unmasking glucose metabolism alterations in stable renal transplant recipients: a multicenter study.

Background And Objectives: Emerging information indicates that glucose metabolism alterations are common after renal transplantation and are associated with carotid atheromatosis. The aims of this study were to investigate the prevalence of different glucose metabolism alterations in stable recipients as well as the factors related to the condition.

Design, Setting, Participants, & Measurements: A multicenter, cross-sectional study was conducted of 374 renal transplant recipients without pre- or posttransplantation diabetes.

The combined effect of pre-transplant triglyceride levels and the type of calcineurin inhibitor in predicting the risk of new onset diabetes after renal transplantation.

Background: Insulin resistance precedes overt diabetes in the general population and hypertriglyceridemia is a reliable marker of the disorder. Thus, patients in the waiting list with hypertriglyceridemia may be at risk for new-onset diabetes after transplantation (NODAT). Objectives.

Carotid atheromatosis in nondiabetic renal transplant recipients: the role of prediabetic glucose homeostasis alterations.

Background: Prediabetic glucose homeostasis alterations are important cardiovascular risk factors but their role in renal transplant recipients (RTR) has not been established.

Methods: In 172 RTRs without pretransplant or de novo diabetes, we measured carotid intima media thickness (c-IMT) and performed an oral glucose tolerance test (OGTT).

Results: In multivariate analysis, age, hypertension and male sex were independently associated with a c-IMT in the third tertile.

Impact of metabolic syndrome on graft function and survival after cadaveric renal transplantation.

Background: The prevalence and consequences of metabolic syndrome after renal transplantation are not well established. Our aims are to analyze in a historic cohort of consecutive renal transplant recipients without diabetes: (1) the prevalence of metabolic syndrome and its evolution to de novo posttransplantation diabetes mellitus (PTDM), and (2) its impact on graft function and graft and patient survival.

Methods: We studied 230 transplant recipients with stable graft function at 1 year (baseline) and at least 18 months of follow-up (assessment date).

Intolerance syndrome in failed renal allografts: incidence and efficacy of percutaneous embolization.

Background: Immunologic intolerance to a failed renal allograft left in situ is referred to as graft intolerance syndrome, the incidence and predictors of which are unknown. Treatment by transcatheter vascular embolization has been reported to be less invasive than transplantectomy. The incidence of graft intolerance syndrome and results of transcatheter vascular embolization as a first therapeutic approach were studied.

Heart valve calcification and calcium x phosphorus product in hemodialysis patients: analysis of optimum values for its prevention.

Background: Prevalence of valve calcification (VC) in end-stage renal disease (ESRD) patients is high and information regarding modifiable predictors is scarce. Our aim was to determine the prevalence of VC in our maintenance hemodialysis (HD) population, and the optimal Ca x P value that most accurately predicted the presence of VC after controlling for comorbidities.

Methods: This was a cross-sectional observational study of a cohort of 52 stable patients on maintenance HD for more than 12 months.

Thyroid transcription factor 1: a marker for lung adenoarinoma in body cavity fluids.

Background: Adenocarcinomas are the most common epithelial malignancies in body cavity fluids. Subclassification of adenocarcinomas according to primary site can be a challenging task. Thyroid transcription factor 1 (TTF-1) is a nuclear transcription factor that is expressed in normal lung, in thyroid, and in their neoplasms.