Comparison of efficacy of induction therapy in low immunologic risk African-American kidney transplant recipients.

African-Americans (AA) have higher acute rejection rates and poorer long-term graft survival rates when compared with non-AA. It is yet to be demonstrated that the type of induction therapy modifies outcomes in this 'high-risk' population. This retrospective analysis compares the efficacy of induction therapy [antilymphocyte antibodies (ALA) versus interleukin-2 receptor antagonists (IL-2RA)] in the AA population.

A Convenient Reagent for Aldehyde to Alkyne Homologation.

An convenient reagent for the one-carbon homologation of an aldehyde to the corresponding alkyne is reported. This reagent allows this conversion to conveniently be carried out on a large scale under ambient conditions.

Testing social cognitive mechanisms of exercise in college students.

Objectives: To determine if different dimensions of outcome expectations are mediators between self-efficacy and exercise among college students.

Methods: Students (n = 290) reported exercise levels, self-efficacy, and expectations using a Web-based questionnaire. Factor analysis was performed to identify dimensions of expectations; regression analyses tested whether each factor mediated the relationship between self-efficacy and exercise.

The epothilone B analogue ixabepilone in patients with advanced hepatobiliary cancers: a trial of the University of Chicago Phase II Consortium.

Purpose: Hepatobiliary cancers respond poorly to cytotoxic chemotherapy. We evaluated the activity and safety of ixabepilone, an epothilone B analogue which stabilizes microtubules, in a phase II trial in patients with advanced cancers of the gallbladder, bile duct, and liver.

Methods: Eligible patients had previously-untreated, histologically-proven unresectable hepatobiliary cancer.

Phase II study of sunitinib malate in head and neck squamous cell carcinoma.

Background: Sunitinib is an orally administered multitargeted tyrosine kinase inhibitor of RET, VEGFR, PDGFR, and c-KIT. We conducted a phase II trial to evaluate the tolerability and efficacy of sunitinib in metastatic and/or recurrent SCCHN patients.

Methods: Patients who had received no more than two prior chemotherapy regimens were eligible and, depending on ECOG performance status (PS), were entered into either Cohort A (PS 0-1) or Cohort B (PS 2).

Implementation of a collaborative drug therapy management service for inpatients receiving direct thrombin inhibitors.

Purpose: The development and implementation of a collaborative drug therapy management (CDTM) service for inpatients receiving direct thrombin inhibitors (DTIs) are described.

Summary: A pharmacist-driven DTI protocol was established to help establish guidelines for the use and monitoring of DTIs to ensure the effective and safe administration of these high-risk medications. The CDTM service and DTI dosing protocol, including order form development, were completed over a two-year period.

A divergent synthesis of the delta(13)-9-isofurans.

A stereodivergent total synthesis of the Delta(13)-9-isofurans has been developed. The four core substituted tetrahydrofurans were prepared by the Sharpless asymmetric epoxidation and Sharpless asymmetric dihydroxylation followed by cascade cyclization. The relative configuration at C-8 was inverted by oxidation followed by immediate L-Selectride reduction.

The use of drotrecogin alfa (activated) in solid organ transplant patients: a case series.

Background: Drotrecogin alfa (activated) (DAA), a recombinant human activated protein C, is indicated for the reduction of mortality in patients with severe sepsis who have a high risk of death. In the initial trial, DAA demonstrated a significant reduction in mortality at 28 days for patients treated with DAA in comparison with standard supportive treatment (placebo). However, solid organ transplant recipients were excluded from the study.

No difference between smokers, former smokers, or nonsmokers in the operative outcomes of laparoscopic donor nephrectomies.

The laparoscopic donor nephrectomy has revolutionized the living donation process for kidney transplantation. Because this surgery is elective and altruistic and smoking has been associated with greater technical difficulty and increased risk for postoperative complications for other types of surgeries, the potential risk of smoking must be addressed with regard to surgical complications. We reviewed 221 laparoscopic kidney donors with known smoking status.

Efficacy of induction therapy on acute rejection and graft outcomes in African American kidney transplantation.

Background: African Americans (AA) have higher rejection rates and poorer graft outcomes compared to non-AAs. Induction therapy is yet unproven in this high risk population.

Methods: This retrospective study compared the efficacy of induction therapy [IL-2 receptor antibodies (IL2RA) or thymoglobulin] vs.

Synthesis of (+)-coronafacic acid.

An enantioselective synthesis of (+)-coronafacic acid has been achieved. Rhodium-catalyzed cyclization of an alpha-diazoester provided the intermediate cyclopentanone in high enantiomeric purity. Subsequent Fe-mediated cyclocarbonylation of a derived alkenyl cyclopropane gave a bicyclic enone that then was hydrogenated and carried on to the natural product.

The effect of a physical activity intervention on bias in self-reported activity.

Purpose: A positive outcome in self-reported behavior could be detected erroneously if an intervention caused over-reporting of the targeted behavior. Data collected from a multi-site randomized trial were examined to determine if adolescent girls who received a physical activity intervention over-reported their activity more than girls who received no intervention.

Methods: Activity was measured using accelerometers and self-reports (3-Day Physical Activity Recall, 3DPAR) in cross-sectional samples preintervention (6th grade, n = 1,464) and post-intervention (8th grade, n = 3,114).

Walking for prevention of cardiovascular disease in men and women: a systematic review of observational studies.

In this systematic review, walking (a generally accessible activity for a largely sedentary population) was assessed as a preventive risk factor for development of fatal and non-fatal cardiovascular disease (CVD). PubMed, CINHAL and reference list searches identified 21 peer-reviewed publications examining walking in relation to CVD; studies assessing active transportation were excluded. Generally, there were dose-dependent reductions in CVD risk with higher walking duration, distance, energy expenditure and pace.

Impact of overweight and obesity on hospitalization: race and gender differences.

Objective: To examine associations between weight status and number of all-cause and cause-specific hospitalizations overall, and by race and gender.

Design: Longitudinal cohort study.

Subjects: White and black adults (n=15 355) from the Atherosclerosis Risk in Communities Study who were normal weight (body mass index: >or=18.

Long-term efficacy of induction therapy with anti-interleukin-2 receptor antibodies or thymoglobulin compared with no induction therapy in renal transplantation.

Background: Although the utility of antibody induction therapy has been demonstrated in clinical trials, the ideal regimen to use based on patient risk factors has not been fully elucidated. The objectives of this study were to determine the impact of either anti-interleukin-2 receptor antibodies (IL-2RA) or thymoglobulin induction therapies versus no induction therapy on acute rejection rates and on 3-year graft survival rates.

Methods: This retrospective analysis compared 3 patient groups-those who did not receive induction, those who received IL-2RA induction, and those who received thymoglobulin induction.

Convenient synthetic route to an enantiomerically pure FMOC alpha-amino acid.

A strategy for the facile alpha-amination of carboxylic acid menthyl esters is described. The resulting diastereomers, readily separable, can be individually carried on to each enantiomer of the FMOC alpha-amino acid. A variety of unnatural side chains were compatible with this approach.

Convenient access to bicyclic and tricyclic diazenes.

Heating the tosylhydrazone of an omega-alkenyl ketone or aldehyde to reflux in toluene in the presence of K(2)CO(3) delivered the bicyclic diazene. Irradiation of the diazene converted it to the cyclopropane. This appears to be a generally useful method for the construction of substituted cyclopentanes and cyclohexanes.

A three-step route to a tricyclic steroid precursor.

2-Alkyl cyclohexenones are useful intermediates for organic synthesis. The Wittig reaction of a series of aldehydes with (cyclopropylmethyl)triphenylphosphonium bromide delivered the corresponding alkenyl cyclopropanes. UV irradiation in the presence of Fe(CO)5 converted the alkenyl cyclopropanes to the 2-substituted cyclohexenones.

Synthesis of (-)-hamigeran B.

The synthesis of (-)-hamigeran B has been achieved, based on a new approach to cyclopentane construction, the rhodium-mediated intramolecular C-H insertion of alpha-aryl-alpha-diazoketones. The endo-isopropyl group was installed by selective hydrogenation of a cyclopropylidene substituent.

Synthesis of Bis-18,18'-desmethyl Ritterazine N.

Bis-18,18'-desmethyl ritterazine N has been prepared in enantiomerically pure form. The synthetic alkaloid, lacking only two of the 52 carbon atoms of the natural product, shows selective activity in the NIH 60 cell panel.

Gefitinib plus celecoxib in chemotherapy-naïve patients with stage IIIB/IV non-small cell lung cancer: a phase II study from the Hoosier Oncology Group.

Background: Gefitinib, an inhibitor of the epidermal growth factor receptor (EGFR) pathway, has single agent activity in non-small cell lung cancer (NSCLC). Preclinical studies demonstrate significant interactions between the EGFR and cyclooxygenase 2 (COX-2) pathways and that simultaneous inhibition may have benefits over EGFR inhibitors alone.

Eligibility Criteria: chemotherapy-naive, stage IIIb (with pleural effusion) or IV NSCLC, Eastern Cooperative Oncology Group Performance Status (PS) 0-1.

A potential route to neuroprostanes and isoprostanes: preparation of the four enantiomerically pure diastereomers of 13-F4t-neuroP.

We report a potential synthetic route to the isoprostanes and the neuroprostanes that could allow ready access to each of the enantiomerically pure diastereomers of the several regioisomers of these important human metabolites. The key transformation in the synthesis is a highly diastereoselective thermal intramolecular ene reaction. A critical observation is that the four enantiomerically pure diastereomers of an intermediate acetylenic ester are easily separated from one another.

Preparation of 2-iodo allylic alcohols from 2-butyn-1,4-diol.

The conversion of 2-butyn-1,4-diol to (Z)-2,4-diiodobut-2-en-1-ol proceeded efficiently using in situ generated trimethylsilyl iodide. Coupling with Grignard reagents and other nucleophiles delivered (2Z)-2-iodo allylic alcohols. The geometry of the products was established by nOe.

Use of renin-angiotensin-aldosterone system inhibitors within the first eight to twelve weeks after renal transplantation.

Objective: To evaluate the safety and efficacy of early initiation of inhibitors of the renin-angiotensin-aldosterone system (RAAS) in renal transplant patients.

Data Sources: A literature search was conducted using MEDLINE (1950-September 2007), PubMed (1966-September 2007), and International Pharmaceutical Abstracts (1970-September 2007) with combinations of the following terms: angiotensin-converting enzyme (ACE) inhibitors, angiotensin II type 1 receptor blockers (ARBs), and kidney transplant. Articles obtained from this search were cross-referenced and bibliographies were checked for all relevant information.