Inequalities in cancer screening, prevention and service engagement between UK ethnic minority groups.

More people in the UK are living with cancer than ever before. With an increasingly ethnically diverse population, greater emphasis must be placed on understanding factors influencing cancer outcomes. This review seeks to explore UK-specific variations in engagement with cancer services in minority ethnic groups and describe successful interventions. The authors wish to highlight that, despite improvement to engagement and education strategies, inequalities still persist and work to improve cancer outcomes across our communities still needs to be prioritised. There are many reasons why cancer healthcare inequities exist for minority communities, reported on a spectrum ranging from cultural beliefs and awareness, through to racism. Strategies that successfully enhanced engagement included language support; culturally-sensitive reminders; community-based health workers and targeted outreach. Focusing on the diverse city of Leicester the authors describe how healthcare providers, researchers and community champions have worked collectively, delivering targeted community-based strategies to improve awareness and access to cancer services.

The Problem of Recurrent Injuries in Collegiate Track and Field.

Background: As with most sports, participating in Track and Field (T&F) has inherent injury risks and a previous injury often predisposes athletes to a greater future injury risk. However, the frequency and burden of recurrent injuries in collegiate T&F have not been closely examined. Purpose: The purpose of this study was to describe the frequency and burden of recurrent injuries in collegiate T&F and compare differences in the time loss associated with initial and recurrent injuries by sex and T&F discipline. Study Design: Descriptive Epidemiology Study. Methods: Data from the NCAA Injury Surveillance Program were analyzed to describe the frequency and burden of recurrent injuries in collegiate T&F between 2009 and 2014. Comparisons of recurrent injury proportions by T&F discipline were made using Injury Proportion Ratios (IPR) and injury-associated time loss comparisons by injury type and sex were made using Negative Binomial Regression. Results: Four hundred and seventy-four injuries were reported, 13.1% of which were classified as recurrent injuries. T&F athletes who competed in jumps experienced a lower proportion of recurrent injuries (6.1%) than runners (14.6%) and throwers (19.2%) (Recurrent IPR 0.40, 95% CI 0.18-0.88, p<0.05). When controlling for sex and injury diagnosis, T&F athletes experienced 50% greater time loss from sport following a recurrent injury than an initial injury (95% CI 17%-107%, p<0.01). Conclusions: Recurrent injuries in T&F athletes account for greater time loss than initial injuries, despite sex or injury diagnosis. The current study indicates a need for further research to assess factors contributing to time loss. Level of Evidence: Level 3.

Coexistence of tumid lupus erythematosus with systemic lupus erythematosus and discoid lupus erythematosus: a report of two cases of tumid lupus.

Tumid lupus erythematosus (LE) is a rare variant of chronic cutaneous LE that is characterized clinically by smooth, nonscarring, pink to violaceous papules or plaques without evidence of surface change. Histopathologic features include superficial and deep lymphocytic infiltration in a perivascular and periadnexal distribution, with dermal interstitial mucin deposition and focal or absent dermoepidermal junction involvement. These clinical and histopathologic features can be challenging to differentiate from other cutaneous diseases. This is particularly true because patients with tumid LE usually do not have other manifestations of systemic LE or cutaneous LE. We present 2 cases of tumid LE, one associated with concomitant systemic LE and the other occurring concurrently with discoid LE. Furthermore, we demonstrate the rare occurrence of a patient with tumid LE occurring below the waist at a photo-protected site.

Synthesis and application of P-stereogenic phosphines as superior reagents in the asymmetric aza-Wittig reaction.

A wide variety of P-stereogenic aryldialkylphosphines were prepared in enantioenriched form by a systematic diversification of the (-)-sparteine-mediated dynamic kinetic resolution of racemic lithiophosphine-boranes reported by Livinghouse. Excellent asymmetric induction was observed provided that the intermediate lithiophosphine/sparteine complex precipitated from solution; more soluble derivatives returned poor ee's or racemic material. The resulting phosphine-boranes were deprotected and used as reagents in the desymmetrizing asymmetric aza-Wittig reaction of 2-alkyl-2-(3-azidopropyl)cyclohexane-1,3-diones, delivering the highest ee's yet observed in this process (up to 84% ee). Phosphines bearing bulky substituents required heating for the aza-Wittig reaction to proceed to completion, which 31P NMR studies showed to be due to interception of the reaction by the formation of unreactive (E)-phosphazides. This was circumvented by use of methyltrioxorhenium to catalyze the formation of iminophosphoranes from the azide and phosphine, allowing reactions to take place at ambient temperature, although the ee's of the asymmetric reactions were reduced in these examples.

Synthesis and antibacterial activity of hydrolytically stable (-)-epicatechin gallate analogues for the modulation of beta-lactam resistance in Staphylococcus aureus.

Hydrolytically more stable analogues of (-)-epicatechin gallate (ECg) have been synthesised from ECg where an amine or amide function has been substituted for the ester linkage that joins the C-ring with the galloyl D-ring. Sub-inhibitory concentrations (25 mg/L) of the amide analogue 7, possessing the natural C-3 stereochemistry, were able to reduce the resistance to oxacillin of three strains of methicillin resistant Staphylococcus aureus (BB 568, EMRSA-15 and EMRSA-16) comparable to levels achieved with ECg.

Neutrophilic eccrine hidradenitis: a case report of an unusual annular presentation.

Neutrophilic eccrine hidradenitis (NEH) is an acute, self-limited, inflammatory neutrophilic dermatosis. It is most commonly described in patients with acute myelogenous leukemia (AML) following chemotherapy. NEH generally presents as erythematous papules and plaques on the head, trunk, and extremities. Histologically, NEH is characterized by a neutrophilic infiltrate surrounding eccrine ducts and coils with occasional necrosis. We describe a case of NEH with an unusual presentation of annular plaques. A search of the literature revealed only one other case report of NEH presenting as an annular eruption.

Asymmetric total synthesis of B-ring modified (-)-epicatechin gallate analogues and their modulation of beta-lactam resistance in Staphylococcus aureus.

Two enantiomerically pure B-ring modified analogues of (-)-epicatechin gallate were synthesised and their modulation of beta-lactam resistance using three strains of methicillin resistant Staphylococcus aureus (BB 568, EMRSA-15 and EMRSA-16) evaluated. Sub-inhibitory concentrations (12.5 and 25 mg/L) of the two analogues fully sensitised each of the three MRSA strains to oxacillin, reducing the MIC to less than 0.5 mg/L, identical to levels achieved with ECg. Lower concentrations demonstrated that the position and degree of hydroxylation of the B-ring is important for activity.

Enantioselective partial reduction of 2,5-disubstituted pyrroles via a chiral protonation approach.

[reaction: see text] The partial reduction of 2,5-pyrrole diester 1 followed by enantioselective protonation in situ to furnish synthetically useful building blocks is described. An enantiomeric excess of up to 74% was achieved using (-)-ephedrine and related analogues as chiral proton sources. The pyrroline product obtained could be recrystallized to give enantiomerically pure material.

Flexibility in the partial reduction of 2,5-disubstituted pyrroles: application to the synthesis of DMDP.

[reaction: see text] The partial reduction of electron-deficient 2,5-disubstituted pyrroles has been developed into a flexible procedure that gives control of relative stereochemistry by variation of the reduction conditions. After the reaction, the pyrroline products were dihydroxylated at C-3,4 to give either the cis or trans isomers; this flexibility means that a variety of polyhydroxylated pyrrolidines can be prepared in a short sequence. Finally, this method was applied to a synthesis of the naturally occurring glycosidase inhibitor DMDP.