Protamine-Induced Bradycardic Arrest in a Diabetic Patient.

Protamine sulfate is a common reversal agent of systemic heparinization used during procedures. While the exact epidemiology of adverse events is unknown, prior allergic response to protamine-containing compounds or concomitant use of neutral protamine Hagedorn (NPH) insulin is associated with an increased risk of tachyarrhythmias and bradyarrhythmias. We present a case of a 68-year-old woman with no prior history of protamine sulfate intolerance that suffered bradycardic arrest following protamine infusion. Healthcare providers should recognize the potential for life-threatening tachyarrhythmias and bradyarrhythmias following protamine reversal, especially in diabetic patients at risk for autonomic dysfunction; medication and allergy review are encouraged prior to heparin reversal, especially in diabetic patients.

Inhibition of Tetrahydrofuran Hydrate Formation in the Presence of Polyol-Modified Glass Surfaces.

Glycerol was conjugated to glass test tube surfaces in four configurations by employing two different silane spacers, covalent attachment to glycerol at either the 1- or the 2-position, and with a succinic acid spacer. The resulting surfaces were tested for their ability to inhibit the nucleation of tetrahydrofuran hydrate (THF hydrate) in comparison with polyvinylpyrrolidone (PVP), a known polymeric inhibitor of THF hydrate formation. Contact angle measurements were used as an indication of surface modification throughout the glass derivatization steps. Of the four final surfaces modified with glycerol, only the coating with (3-aminopropyl)triethoxysilane (APTES) and glycerol coupled at the 1-position (leaving a free 1,2-diol) showed significant inhibition of the formation of THF hydrate. The corresponding N-[3-(trimethoxysilyl)propyl]-ethylenediamine (AEAPTMS) coating with glycerol coupled at the 1-position did not show a significant difference over the untreated test tubes. Attachment of glycerol at the 2-position yielded a coating with no benefit over the untreated test tubes regardless of the silane used, and a surface modified with APTES and succinic acid alone enhanced the formation of THF hydrate. The ability to inhibit THF hydrate formation using a polyol-modified surface is a first step in the development of a coating that, alone or in combination with known gas hydrate inhibitors, could be used to prevent gas hydrates from plugging pipelines in field applications.

N-Ethyl-2-[1-(2-hy-droxy-4-methyl-phen-yl)ethyl-idene]hydrazinecarbo-thio-amide.

The title compound, C12H17N3OS, crystallizes with two independent mol-ecules (A and B) in the asymmetric unit. The dihedral angle between the mean planes of the benzene ring and the hydrazinecarbo-thio-amide group are 6.9 (4) and 37.2 (5)° in mol-ecules A and B, respectively. An intra-molecular O-H⋯N hydrogen bond is observed in each mol-ecule. This serves to maintain an approximately planar conformation for mol-ecule A, but leaves a significant twist between these two groups in mol-ecule B. In the crystal, a weak N-H⋯S inter-action is observed, forming inversion dimers among the B mol-ecules and resulting in an R 2 (2)(8) motif. These dimers are further inter-connected by weak N-H⋯O and C-H⋯O inter-molecular inter-actions, forming chains along [011].