XtalFluor-E® mediated proto-functionalization of N-vinyl amides: access to N-acetyl N,O-acetals.

XtalFluor-E® has been extensively used in a broad range of reactions in the past few years. Here we report its use with protic nucleophiles in a catalytic manner for the in situ generation of protons that lead to the proto-functionalization of activated olefins. Utilizing the latter protocol, proto etherification of enamides gives rise to N,O-acetals in nearly quantitative yields.

Effect of 5% benzocaine gel on relieving pain caused by fixed orthodontic appliance activation. A double-blind randomized controlled trial.

AIM: To compare the effectiveness of 5% benzocaine gel and placebo gel on reducing pain caused by fixed orthodontic appliance activation. SETTING AND SAMPLE POPULATION: Thirty subjects (15-25 years) undergoing fixed orthodontics. METHODS AND MATERIALS: A randomized, double-blind, placebo-controlled and cross-over clinical trial study was conducted. Subjects were asked to apply a placebo gel and 5% benzocaine gel, exchangeable in two consecutive appointments, twice a day for 3 days and mark their level of pain on a VAS scale. The pain severity was evaluated by means of Mann-Whitney U-test for comparing two gel groups, Kruskal-Wallis nonparametric test for overall differences and post hoc test of Dunnett for paired multiple comparisons. p-value was assigned <0.05. RESULTS: The overall mean value of pain intensity for benzocaine and placebo gels was 0.89 and 1.15, respectively. The Mann-Whitney U-test indicated that there was no significant difference between overall pain in both groups (mean difference = 0.258 p ˂ 0.21). For both groups, pain intensity was significantly lower at 2, 6 and 24 h compared with pain experienced at days 2, 3 and 7. CONCLUSION: Benzocaine gel caused a decrease in pain perception at 2 h compared with placebo gel. Peak pain intensity was at 2 h for placebo gel and at 6 h for benzocaine gel, followed by a decline in pain perception from that point to day 7 for both gels.

Sentinel node biopsy in endometrial cancer: systematic review and meta-analysis of the literature.

PURPOSE: Sentinel lymph node biopsy is a fairly new approach for staging of gynecological malignancies. In the current study, the authors comprehensively reviewed the available reports on sentinel node biopsy of endometrial cancer. MATERIALS AND METHODS: The authors searched Medline, SCOPUS, ISI web of knowledge, Science Direct, Springer, OVID SP, and Google Scholar with the following search terms: "endometrium OR endometrial OR uterine OR uterus AND sentinel". The outcomes of interest were detection rate and sensitivity. RESULTS: Overall, 35 studies had enough information for false negative rate evaluation and 51 studies (including the sub-groups of individual studies) for detection rate evaluation (2,071 patients overall). Pooled detection rate was 77.8% (95% CI: 73.5-81.5%) and pooled sensitivity was 89% (95% CI: 83-93%). Cervical injection, as well as using both blue dye and radiotracer, results in higher detection rate and sensitivity. New techniques such as fluorescent dye injection and robotic-assisted surgery showed high detection rate and sensitivity. CONCLUSION: Sentinel node mapping is feasible in endometrial cancer. Using both blue dye and radiotracer and cervical injection of the mapping material can optimize the sensitivity and detection rate of this technique. Larger studies are still needed to evaluate the false negative rate and the factors influencing the sensitivity before considering this method safe.

The accuracy of sentinel node biopsy in breast cancer patients with the history of previous surgical biopsy of the primary lesion: systematic review and meta-analysis of the literature.

BACKGROUND: One of the subjects under debate in sentinel node mapping is the eligibility of patients with the history of previous surgical biopsy of the primary lesion for sentinel node biopsy. In the current systematic review, we evaluated the false negative and detection rates of sentinel node biopsy in breast cancer patients with and without previous surgical manipulation of the primary breast lesions. METHODS: Pubmed, SCOPUS, and Google scholar were searched for any relevant study with head to head comparison of patients with and without history of previous surgical manipulation of the primary breast lesions. The outcomes of interest were detection and false negative rates in each group, and odds ratio as well as risk difference of having sentinel node detection failure or getting false negative results in the surgical biopsy compared to the non-surgical biopsy group. RESULTS: 18 studies for false negative rate and 68 studies for detection rate evaluation were included in this review. Pooled detection rates for patients with and without previous surgical biopsy were 91.3% and 92.8%. Odds ratio and risk difference of having detection failure during surgery were 1.16 and 0.002 respectively. Pooled false negative rates for patients with and without previous surgical biopsy were 12.3% and 9.9%. Odds ratio and risk difference of having false negative results were 1.4 and 0.02 respectively. CONCLUSION: Surgical biopsy of the primary breast malignant lesions does not affect the detection rate of sentinel lymph node biopsy procedure. However, false negative rate seems to be slightly higher. We believe that the advantages of sentinel node biopsy outweigh this small difference.

Sentinel node mapping in the prostate cancer. Meta-analysis.

AIM: Sentinel node (SN) biopsy is becoming a standard procedure in the management of several malignancies. Several groups have evaluated the feasibility and value of this procedure in prostate cancer patients. In the current meta-analysis, we comprehensively and quantitatively summarized the results of these studies. METHODS: Several databases including Medline, SCOPUS, Google Scholar, Ovid, Springer, and Science direct were systematically searched for the relevant studies regarding SL biopsy in the prostate cancer ("prostate" AND "sentinel" as search keywords). The outcomes of interest were sensitivity and detection rate of the procedure. RESULTS: For detection rate and sensitivity 21 and 16 studies met the criteria of inclusion respectively. Pooled detection rate was 93.8% (95% CI 89-96.6%). Cochrane Q value was 216.077 (I2 = 89.81% and p < 0.001). Pooled sensitivity was 94% (95% CI 91-96%). Cochrane Q value was 14.12 (I2 = 0.0 and p = 0.516). CONCLUSION: SL biopsy can prevent unnecessary pelvic lymph node dissection in prostate cancer patients. This procedure is feasible with low false negative rate and high detection rate.

Effect of feeding a docosahexaenoic acid-enriched nutriceutical on the quality of fresh and frozen-thawed semen in Holstein bulls.

The aim of the current study was to investigate the effect of feeding a DHA-enriched nutriceutical on the in vitro quality and sperm motility parameters of fresh and frozen-thawed bull semen assessed by CASA. Samples were obtained from nineteen Holstein bulls used for semen collection at Semen Production Center, Karaj, Iran. Control group (n = 10) were fed a standard concentrate feed while treatment group bulls (n = 9) had this standard feed top dressed with 100 g of a commercially available DHA-enriched nutriceutical. Semen quality was assessed on ejaculates collected at the baseline and after 5, 9, and 12 weeks of supplementation. Classical semen evaluation, assessment of sperm motility (subjective and computer-assisted), viability (eosin-nigrosin), and hypo-osmotic swelling test (HOST) were conducted. Semen volume, sperm concentration, and consequently total sperm output were not affected by dietary treatment (P > 0.05). Feeding the nutriceutical was indeed found to affect sperm motility parameters assessed by CASA after 9 weeks of trial. The treatment has improved total motility (P < 0.01), progressive motility (P < 0.05), average path velocity (P < 0.05), HOST-positive (P < 0.01), and proportion of rapid spermatozoa (P < 0.01) in the fresh semen of bulls. Moreover, the proportion of viable spermatozoa increased (P < 0.05) in the ejaculates collected from nutriceutical-fed bulls compared to the control after 12 weeks of feeding trial. The post-thawed HOST and sperm motility data obtained by CASA did not differ between two groups (P > 0.05). On the other hand, dietary supplementation did not affect body weight, BCS and scrotal circumference. Consequently, it can be concluded that dietary DHA supplementation or its precursors, improve in vitro quality and motility parameters of fresh semen assessed by CASA in Holstein bulls. However, this effect was not pronounced in frozen-thawed semen.

The relationship of plasma leptin concentration and puberty in Holstein bull calves (Bos taurus).

The objective of this experiment was to study the changes of plasma leptin concentration during puberty and its relationship with testosterone level and testis dimensions in Holstein bull calves. Six Iranian Holstein bull calves with approximately 6 months of age were used. Semen evaluation was conducted at 1-month interval to determine the puberty state. To detect the plasma leptin and testosterone changes, blood samples were collected from the jugular vein during pre-puberty (6-7 months of age), puberty (8-9 months of age) and post-puberty (10-11 months of age). In addition, body weight (BW), body condition score (BCS) and testicular width and length were measured at 3-week intervals. The effects of time (age) on total sperm number and percentage of progressive motility of sperm, plasma concentration of leptin and testosterone, amplitude and frequencies of testosterone, BW, BCS, testicular dimensions were significant. Sperm number and progressive motility during post-puberty were higher than those during puberty and pre-puberty. Plasma concentration of leptin during the pre-puberty was higher than those during puberty and post-puberty (p < 0.01). Mean plasma testosterone concentrations during puberty were higher than those during pre-puberty (p < 0.05). BW, BCS and testicular dimensions consistently increased throughout the trial. Results indicated that in growing bull calves, plasma concentrations of leptin decreased during puberty, while circulating testosterone increased.

Pregnancy outcome following in vitro fertilization-embryo transfer (IVF-ET) in women aged < 37, undergoing ovulation induction with human FSH compared with recombinant FSH: a randomised controlled study.

OBJECTIVE: To compare the pregnancy outcome in patients undergoing in vitro fertilization-embryo transfer (IVF-ET) cycles, using human derived follicle-stimulating hormone (FSH) or recombinant FSH for ovarian stimulation protocols. DESIGN: Prospective, multi-centre, randomized controlled trial. PATIENTS: 115 infertile patients undergoing a first attempt of in vitro fertilization and embryo transfer were included in the study. The inclusion criteria were: female age < 37 years and use of GnRH agonist (GnRH-a) for pituitary downregulation. INTERVENTIONS: Long Protocol-controlled ovarian stimulation with human derived FSH or recombinant FSH for IVF-ET. MAIN OUTCOME MEASURES: Primary endpoints were implantation rate, clinical pregnancy rate and spontaneous abortion rate. Secondary end-points were total units of FSH injected, days of stimulation, peak estradiol levels at point of hCG administration, mean number of oocytes at pick-up, fertilization rate and cleavage rate. RESULTS: No statistically significantly differences in pregnancy outcomes were found in the patients receiving hFSH in comparison to patients receiving rFSH. CONCLUSIONS: This study did not demonstrate a difference between the use of h-FSH vs r-FSH for ovarian stimulation in terms of pregnancy outcome, in good prognosis patients undergoing their first IVF-ET procedure.

Invasive Vibrio cholerae 01 E1 Tor Inaba in a 3-day-old neonate: case report.

A 3-day-old girl with invasive V. cholerae infection is described. Her mother had cholera in the perinatal period. Because of retracted nipples, she expressed milk and fed her infant by bottle. The infant died on the 2nd day of admission.

Use of ethinyl estradiol to reverse the antiestrogenic effects of clomiphene citrate in patients undergoing intrauterine insemination: a comparative, randomized study.

OBJECTIVE: To compare the effectiveness of clomiphene citrate used alone and in combination with ethinyl E2 for the induction of ovulation in patients undergoing IUI. DESIGN: Randomized, double-blind study. SETTING: Four infertility treatment centers. PATIENT(S): Women aged 25-35 years with infertility of at least 2 years' duration and oligomenorrhea or amenorrhea associated with a positive menstrual response to an IM progesterone challenge. INTERVENTION(S): A total of 64 patients were randomized to treatment with CC (100 mg daily for 5 days) or CC (100 mg daily for 5 days) plus ethinyl E2 (0.05 mg daily for 5 days). MAIN OUTCOME MEASURE(S): The uterine artery pulsatility index, number of preovulatory follicles, endometrial thickness, and pregnancy rate. RESULT(S): Both treatment regimens increased FSH, LH, and 17beta-E2 levels, with no statistically significant differences. There was a statistically significant difference in endometrial thickness between the two treatment groups. No statistically significant differences were noted in pulsatility index values or in the number of preovulatory follicles. CONCLUSION(S): Ethinyl E2 can reverse the deleterious effects of CC on endometrial thickness, which may contribute to higher pregnancy rates.

Ovarian stimulation using a new highly purified urinary FSH: a prospective randomized clinical study.

The aim of this study was to determine the effectiveness of a new highly purified urinary FSH. A total of 60 in vitro-fertilization (IVF) patients, undergoing embryo transfer (ET) for the first time, were randomly allocated into two groups: Group A (n = 30). Subcutaneous administration of urinary follicle-stimulating hormone (FSH, Fostimon 75, A.M.S.A., Italy). Group B (n = 30). Subcutaneous administration of urinary follicle-stimulating hormone (FSH, Metrodin 75 HP, Serono, Italy). Statistical analysis was performed using the chi-square test, p < 0.05 was assumed as significant. This prospective randomized clinical study in an IVF-ET program showed that both drugs were equally safe and effective. Except for the number of the high quality embryos (3.16 vs 2.9; p = 0.03) the two groups did not differ in stimulation parameters or clinical pregnancy rates per attempt and per transfer. On the other hand, a mean number of 3.56 vs 2.18 embryos were cryopreserved in group A and in group B, respectively, as a result of the high number of mature oocytes and high quality embryos. When frozen embryos cycles were included, the difference in pregnancy rate became significant.