Aortic dissection in childhood and adolescence: an analysis of occurrences over a 10-year interval in New York State.

BACKGROUND: Rarely occurring in the pediatric and adolescent population, aortic dissection is a condition with many predisposing factors. Previous studies have suggested that congenital cardiovascular disorders are the most common predisposing conditions. Trauma-associated aortic dissection is considered a rare occurrence. METHODS: The Statewide Planning and Research Cooperative System database of New York State was used to retrieve cases of aortic dissection in persons < or = 21 years old over a 10-year period. A retrospective analysis for risk or associated conditions was undertaken. RESULTS: Forty-five of a total of 12,142 cases of aortic dissection (0.37%) occurred in persons < or = 21 years old. No patient was younger than 15 years of age. Six of the 45 died (13%). Most patients were male (37 of 45, or 82%). Contrary to previous reports, the most common associated condition was trauma (19 of 45, or 42%), with Marfan syndrome the second most common (11 of 45, or 24%). Ten of 45 adolescent and young adult patients (22%) had no apparent risk factors. CONCLUSIONS: Traumatic aortic disruptions must be considered in children and adolescents who survive serious chest trauma. Family members of pediatric and young adult patients with trauma-associated aortic dissection may need to be evaluated for possible risk of aortic dissection.

Charge-transfer spectra of structurally characterized mixed-valence thiolate-bridged Cu(I)/Cu(II) cluster complexes.

A series of Cu(II) and Cu(I)/Cu(II) complexes containing the cis-N(amine)(2)S(thiolate)(2) copper complex rac-2 has been synthesized to provide a basis for understanding the charge-transfer spectra of mixed-valence thiolate-bridged Cu(I)/Cu(II) complexes. In combination with Cu(Me(2)-13-N(4)ane), rac-2 yields a monobridged dinuclear homovalent adduct, rac-5, while reaction with CuCl yields the mixed-valance pentanuclear complex rac-6. In the presence of Cu(II)(acac)(2), chiral R,R-1 reacts to form a mixed-valence pentanuclear cation R,R-7. rac-6 exhibits a relatively short Cu(I). Cu(II) contact [2.8231(9) A] and associated structural features that suggest the presence of a weak Cu(I).Cu(II) interaction in a valence-trapped system. Additional structural features in rac-6 and R,R-7 include singly and doubly bridging thiolates, three- and four-coordinated Cu(I) ions, and varying Cu(I) ligand sets. These features extend the types and complexities of electronic absorptions significantly. Spectra of rac-6 and R,R-7 exhibit multiple overlapping absorptions over the entire visible and ultraviolet spectral regions studied, consonant with these observations. Trends resulting from variations in structure type and oxidation state permit a first approach toward developing a detailed assignment of the individual ligand Rydberg, LF, LMCT, MLCT, and possible MMCT absorptions in these complexes.