Association of Cytogenetics Aberrations and IGHV Mutations with Outcome in Chronic Lymphocytic Leukemia Patients in a Real-World Clinical Setting.

Immunoglobulin heavy chain variable ( IGHV ) region mutations, TP53 mutation, fluorescence in situ hybridization (FISH), and cytogenetic analysis are the most important prognostic biomarkers used in chronic lymphocytic leukemia (CLL) patients in our daily practice. In real-life environment, there are scarce studies that analyze the correlation of these factors with outcome, mainly referred to time to first treatment (TTFT) and overall survival (OS). This study aimed to typify IGHV mutation status, family usage, FISH aberrations, and complex karyotype (CK) and to analyze the prognostic impact in TTFT and OS in retrospective study of 375 CLL patients from a Spanish cohort. We found unmutated CLL (U-CLL) was associated with more aggressive disease, shorter TTFT (48 vs. 133 months, p < 0.0001), and shorter OS (112 vs. 246 months, p < 0.0001) than the mutated CLL. IGHV3 was the most frequently used IGHV family (46%), followed by IGHV1 (30%) and IGHV4 (16%). IGHV5-51 and IGHV1-69 subfamilies were associated with poor prognosis, while IGHV4 and IGHV2 showed the best outcomes. The prevalence of CK was 15% and was significantly associated with U-CLL. In the multivariable analysis, IGHV2 gene usage and del13q were associated with longer TTFT, while VH1-02, +12, del11q, del17p, and U-CLL with shorter TTFT. Moreover, VH1-69 usage, del11q, del17p, and U-CLL were significantly associated with shorter OS. A comprehensive analysis of genetic prognostic factors provides a more precise information on the outcome of CLL patients. In addition to FISH cytogenetic aberrations, IGHV and TP53 mutations, IGHV gene families, and CK information could help clinicians in the decision-making process.

Estrategia de apropiación social del conocimiento en la isquemia cardiaca / Strategy for the social appropriation of knowledge in myocardial ischemia

Introducción: La construcción de conocimiento a partir del intercambio de saberes entre pacientes, familias y equipo de salud es una necesidad sentida que puede impactar en la educación en salud y la adherencia a los tratamientos. Objetivo: Desarrollar una estrategia de apropiación social que permita innovar en el cuidado de la salud de las personas con enfermedad isquémica cardiaca y sus familias mediante el uso de la herramienta MHealth. Materiales y Métodos: Estudio exploratorio que permitió el diseño de una estrategia de apropiación social de conocimiento para mejorar la salud cardiovascular de personas que sufren isquemia cardiaca. Participaron 31 personas entre pacientes, familiares, profesionales de la salud. Se desarrollaron dos talleres virtuales en el mes de junio y seguimientos telefónicos entre agosto y septiembre. Las experiencias y saberes de los participantes, permitió la construcción de la herramienta MHealth. Resultados: La reflexión crítica entre los actores facilitó la construcción y desarrollo de la herramienta tipo MHealth (página web/app) titulada "Cuidando tu corazón", que permite el acceso a información relacionada con el cuidado durante la isquemia cardiaca y articula información a partir del diálogo de saberes y la evidencia reportada en la literatura. Discusión: Las estrategias de apropiación social son una herramienta relevante para la generación de conocimiento en el área de la salud. Conclusiones: La estrategia implementada permitió reconocer la importancia de contar con herramientas para el cuidado de la salud cardiovascular elaboradas desde las necesidades, perspectivas y creencias de sus actores para mejorar la educación y el cuidado.

Introduction: The construction of knowledge from the exchange of knowledge between patients, families, and healthcare teams is a felt need that can impact health education and adherence to treatment. Objective: To develop a social appropriation strategy that enables innovation in the health care of people with ischemic heart disease and their families through the use of an MHealth tool. Materials and methods: Exploratory study that allowed the design of a strategy for the social appropriation of knowledge to improve the cardiovascular health of people suffering from myocardial ischemia. Thirty-one people participated, including patients, family members, and health professionals. Two virtual workshops were held in June, and follow-up phone calls were made between August and September. The participant's experiences and knowledge enabled the construction of the MHealth tool. Results: The critical reflection of the stakeholders facilitated the construction and development of the MHealth tool (webpage/app) named "Cuidando tu corazón" (Taking care of your heart). Discussion: Social appropriation strategies are a relevant tool for knowledge creation in health. Conclusions: The strategy implemented made it possible to recognize the importance of developing cardiovascular healthcare tools from stakeholders' needs, perspectives, and beliefs to improve education and care.

Introdução: A construção do conhecimento a partir da troca de conhecimentos entre pacientes, familiares e equipe de saúde é uma necessidade sentida que pode impactar na educação em saúde e na adesão aos tratamentos. Objetivo: Desenvolver uma estratégia de apropriação social que permita inovar na atenção à saúde de pessoas com doença isquêmica do coração e seus familiares por meio do uso da ferramenta MHealth. Materiais e Métodos: Estudo exploratório que permitiu desenhar uma estratégia de apropriação social do conhecimento para melhorar a saúde cardiovascular de pessoas com isquemia cardíaca. Participaram 31 pessoas, entre pacientes, familiares e profissionais de saúde. Foram realizadas dois seminários virtuais em junho e acompanhamentos por telefone entre agosto e setembro. As experiências e conhecimentos dos participantes permitiram a construção da ferramenta MHealth. Resultados: A reflexão crítica entre os atores facilitou a construção e desenvolvimento da ferramenta do tipo MHealth (página web/ aplicativo) intitulada "Cuidando do seu coração", que permite o acesso às informações relacionadas aos cuidados durante a isquemia cardíaca e articula as informações a partir do diálogo de conhecimento e as evidências relatadas na literatura. Discussão: As estratégias de apropriação social são uma ferramenta relevante para a geração de conhecimento na área da saúde. Conclusões: A estratégia implementada possibilitou reconhecer a importância de ter ferramentas para o cuidado à saúde cardiovascular elaboradas a partir das necessidades, perspectivas e crenças de seus atores para melhorar a educação e o cuidado.

Extending in aqua portal dosimetry with dose inhomogeneity conversion maps for accurate patient dose reconstruction in external beam radiotherapy.

Background and purpose: In aqua dosimetry with electronic portal imaging devices (EPIDs) allows for dosimetric treatment verification in external beam radiotherapy by comparing EPID-reconstructed dose distributions (EPID_IA) with dose distributions calculated with the treatment planning system in water-equivalent geometries. The main drawback of the method is the inability to estimate the dose delivered to the patient. In this study, an extension to the method is presented to allow for patient dose reconstruction in the presence of inhomogeneities. Materials and methods: EPID_IA dose distributions were converted into patient dose distributions (EPID_IA_MC) by applying a 3D dose inhomogeneity conversion, defined as the ratio between patient and water-filled patient dose distributions computed using Monte Carlo calculations. EPID_IA_MC was evaluated against dose distributions calculated with a collapsed cone convolution superposition (CCCS) algorithm and with a GPU-based Monte Carlo dose calculation platform (GPUMCD) using non-transit EPID measurements of 25 plans. In vivo EPID measurements of 20 plans were also analyzed. Results: In the evaluation of EPID_IA_MC, the average γ-mean values (2% local/2mm, 50% isodose volume) were 0.70 ± 0.14 (1SD) and 0.66 ± 0.10 (1SD) against CCCS and GPUMCD, respectively. Percentage differences in median dose to the planning target volume were within 3.9% and 2.7%, respectively. The number of in vivo dosimetric alerts with EPID_IA_MC was comparable to EPID_IA. Conclusions: EPID_IA_MC accommodates accurate patient dose reconstruction for treatment disease sites with significant tissue inhomogeneities within a simple EPID-based direct dose back-projection algorithm, and helps to improve the clinical interpretation of both pre-treatment and in vivo dosimetry results.

Hypermetabolic abdominal and cervical lymph nodes mimicking Hodgkin lymphoma relapse on FDG PET/CT after adenovirus-vectored COVID-19 vaccine.

Vaccine-associated hypermetabolic lymphadenopathy (VAHL) has been reported as a common post-vaccination side effect, especially with mRNA-based COVID-19 vaccines. Most VAHL cases present normal or enlarged regional lymph nodes close to the injection site, usually with mild-moderate FDG (18 F-Fluorodeoxyglucose) uptake on FDG positron emission tomography (PET)/CT. Here, we describe the case of a 33-year-old woman with past history of Classic Hodgkin Lymphoma (CHL) who underwent follow-up FDG PET/CT 3 days (d) after the first dose of the adenovirus-vectored Oxford-AstraZeneca COVID-19 vaccine. FDG PET/CT showed unexpected small hypermetabolic cervical and abdominal lymph nodes in the same location as at the onset of the disease, suggesting radiological relapse. Considering temporal relationship and other cases of VAHL, a new image was performed 2 months later, which revealed decreased lymph nodes and normalization of FDG uptake. This case illustrates that the possibility of a false-positive should always be considered by physicians in this new context, even when hypermetabolic lymph nodes appear far from the vaccination site.

Incidence and clinical profile of venous thromboembolism in hospitalized COVID-19 patients from Madrid region.

BACKGROUND: COVID-19 related in-hospital venous thromboembolism (VTE) incidence is high but data reported vary significantly. Some studies show that up to half of the events are diagnosed early after admission. OBJECTIVES: To study symptomatic VTE incidence in acute COVID-19 hospitalized patients and to describe timing of VTE diagnosis. METHODS: Multicenter cohort of 5966 patients hospitalized with acute COVID-19. Multicenter Registry of 844 hospitalized patients with acute COVID-19 and associated acute VTE. RESULTS: By the time of cohort data collection, 68 patients (1.14%) were still hospitalized, 19.8% had died, and 5.4% required ICU. During a median follow-up of 6 days (IQR, 4-12), 183 patients (3.07%; 95% CI, 2.64-3.55) presented a symptomatic VTE event. The cumulative incidences of VTE at 7, 14 and 21 days in wards [2.3% (95% CI, 1.9-2.7), 3.6% (95% CI, 3.0-4.3), and 4.3% (95% CI, 3.5-5.1)] were similar to the ones reported in ICU [2.2% (95% CI, 1.0-4.4), 2.9% (95% CI, 1.5-5.3), and 4.1% (95% CI, 2.2-6.8)], but at 30 and 60 days were higher in ICU [6.9% (95% CI, 4.2-10.5), and 12.8% (95% CI, 8.1-18.5)] than in wards. Eighty-eight VTE events (48%) were diagnosed early, within 48 h of admission. VTE was not associated with death (HR, 0.79; 95% CI, 0.55-1.12). CONCLUSIONS: Incidence of symptomatic VTE in our COVID-19 cohort is consistent with that of other real-life studies recently published. Early VTE events are, along with COVID-19, the reason for admission rather than an in-hospital complication.

Risk factors for short-term postoperative complications in the 8 weeks after tibial plateau leveling osteotomy in dogs weighing less than 15 kilograms: A retrospective study.

The purpose of this retrospective study was to evaluate the risk factors for short-term postoperative complications in the 8 weeks after unilateral tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament rupture in small dogs weighing less than 15 kg. Medical records were retrospectively reviewed for 90 dogs weighing <15 kg that underwent medial parapatellar arthrotomy with inspection of the meniscus and TPLO performed by the same surgeon between January 2012 and December 2017. The overall complication rate was 4.44% (4/90 dogs). There were four cases of partial incisional dehiscence, none of which required surgical revision. Complications were significantly more likely in dogs that had undergone placement of a 2.4-mm TPLO plate. Overall, the complication rate was less than that in previous studies of dogs weighing > 15kg. In this study, patients in which 2.4-mm TPLO plates were used were more likely to develop postoperative complications. Dogs weighing <15 kg that underwent TPLO had good short-term outcomes with minimal complications. In our study, the overall complication rate after TPLO in dogs weighing <15 kg is less than that historically reported in heavier dogs. Our data suggests that TPLO is a safe treatment option in small dogs with cranial cruciate ligament rupture.

The International Prognostic Index for Patients with Chronic Lymphocytic Leukemia Has the Higher Value in Predicting Overall Outcome Compared with the Barcelona-Brno Biomarkers Only Prognostic Model and the MD Anderson Cancer Center Prognostic Index.

In recent years, new prognostic indexes (PIs) for chronic lymphocytic leukemia (CLL), which include clinical, biological, and genetic variables, have been validated, highlighting the MD Anderson Cancer Center prognostic index (MDACC PI), the CLL-international prognostic index (CLL-IPI), and the Barcelona-Brno biomarkers only prognostic model. The aim of this study is to compare the utility of these PIs in a cohort of Spanish patients. A retrospective analysis of 696 unselected CLL patients newly diagnosed and previously untreated from different Spanish institutions was performed. The MDACC PI, the CLL-IPI, and the biomarkers only PI were applied to these patients, and a comparison of the three PIs was performed. With a median follow-up time of 46 months, 394 patients were alive and 187 had received treatment. The median overall survival (OS) was 173 months and the median time to first therapy (TTFT) was 32 months. Significant differences were obtained in OS and TTFT for all subgroups when applying these PIs, with the CLL-IPI being the one with the higher c-index (0.676 for OS and 0.757 for TTFT). The three PIs were able to discriminate patients in different prognostic subgroups. In our cohort, the CLL-IPI showed higher power in predicting TTFT and OS.

Seizure susceptibility in the APP/PS1 mouse model of Alzheimer's disease and relationship with amyloid ß plaques.

Alzheimer's disease is a common age associated neurodegenerative disorder associated with an elevated risk of seizures that may be fundamentally connected to cognitive dysfunction. We used 4-9month-old mice of the APP/PS1 mouse model of Alzheimer's disease to study the presence of epileptiform-like discharges and to establish if the amyloid-ß plaques affect their generation. The EEG of the APP/PS1 transgenic mice revealed a higher incidence of epileptiform-like discharges i.e. seizure events (interictal spikes, sharp waves, or polyspikes) than in the controls. Also, APP/PS1 mice showed a lower latency to evoke seizure events than in the control animals when pentylenetetrazole (60mg/kg; i.p.) was injected. Moreover, physostigmine injection (1mg/kg; i.p.) also increased the frequency of spontaneous epileptiform-like discharges in the APP/PS1 mice. We also found a correlation between the frequency of epileptiform-like discharges and the number of amyloid-ß plaques. Application of N-(2-chloroethyl)-N-ethyl-bromobenzylamine (50mg/kg) generated amyloid-ß plaques in the cortex and seizure activity appeared. Taken together, these data indicate that deposits of amyloid-ß plaques may be responsible for the epileptiform-like discharges recorded in the APP/PS1 mice and could be responsible for the elevated risk for seizures of Alzheimer's patients.

Calidad de vida en el trabajo en funcionarios del área de Seguridad y Vigilancia de una universidad del suroccidente colombiano / Quality of work life in employees of a Security and Surveillance area of a southwest colombian university

Objetivo: Evaluar la percepción de la Calidad de Vida en el Trabajo (CVT) de los funcionarios que laboran en al área de Seguridad y Vigilancia de una Universidad del suroccidente Colombiano. Métodos y Materiales: Estudio de tipo cuantitativo, descriptivo y de corte transversal. Muestra constituida por 122 personas de una población de 137. Se aplicó un cuestionario de datos socio-laborales integrado por 19 ítems y por el instrumento CVT-GOHISALO, que consta de 74 ítems y mide la CVT en siete dimensiones. Resultados: De las siete dimensiones evaluadas, los funcionarios del área de seguridad y vigilancia perciben que la dimensión seguridad en el trabajo contribuye de manera positiva a la CVT; las dimensiones: soporte institucional, satisfacción por el trabajo, bienestar logrado a través del trabajo e integración al puesto de trabajo contribuyen medianamente a una percepción positiva de la calidad de vida laboral, mientras las dimensiones: desarrollo personal del trabajador y administración del tiempo libre puntuaron bajo contribuyendo de manera negativa a dicha percepción. Finalmente se identificó relación entre la antigüedad en la empresa y la dimensión seguridad en el trabajo y las variables: sede donde labora y estado civil con las dimensiones: bienestar logrado a través del trabajo y satisfacción por el mismo. Conclusiones: Los trabajadores del área de seguridad y vigilancia evidencian sus percepciones de CVT que señalan los factores intra y extra laborales en los que se encuentran inmersos, reflejando una realidad de su medio labora (AU)

Objective: To evaluate the perception of the Quality of Work Life (QWL) of employees who work in the Security and Surveillance area of a Southwest Colombian University. Methods and Materials: Quantitative, descriptive and cross-sectional study. The sample consists of 122 people from a population of 137. A questionnaire of social and labor data composed of 19 items was applied and the CVT-GOHISALO instrument, which consists of 74 items and measures the QWL in seven dimensions. Results: Of the seven dimensions evaluated, security and surveillance workers perceive that the employment stability dimension contributes positively to the QWL. Institutional support, job satisfaction, well-being condition achieved through work and job integration dimensions, contribute moderately to a positive QWL perception, while worker personal development and leisure time administration dimensions scored low contributing negatively to that perception. Finally, the relationship between seniority in the company with the employment stability dimension together with workplace and marital status variables and with the dimensions well-being achieved through work and job satisfaction were identified. Conclusions: Workers in the area of security and surveillance show their perceptions of QWL that highlight the intra and extra labor factors in which they are immersed, reflecting a reality of their work environment (AU)

Interacciones medicamentosas de los anticonvulsivantes de primera línea con antipsicóticos y/o antidepresivos / Drug interactions of old antiepileptic drugs with antidepressants and antipsychotics

Objetivo: Identificar interacciones medicamentosas de los anticonvulsivantes de primera línea con antipsicóticos y/o antidepresivos y su impacto en el paciente con epilepsia en el Hospital de San José, Bogotá, que asistieron a la consulta externa desde el 1 de junio del 2015 hasta el 30 de abril del 2016. Materiales y métodos: Estudio descriptivo para identificar las interacciones medicamentosas en pacientes con epilepsia. Se incluyó a 26 pacientes ≥ 18 años con los criterios de la International League Against Epilepsy en terapia con antiepilépticos de primera línea asociados a medicamentos antipsicóticos y/o antidepresivos; se excluyó a embarazadas y aquellos con alteración hepática y renal. El análisis descriptivo se realizó por medio de frecuencias absolutas y relativas para las variables cualitativas, y para las cuantitativas medianas y rangos intercuartílicos. Resultados: La mediana de edad fue 49 años (RIC: 33-57), 14 (53,8%) eran mujeres. Antecedentes relevantes: hipoxia perinatal y traumatismo craneoencefálico en 5 (19,2%). La monoterapia anticonvulsivante más frecuente fue carbamazepina en 8 casos (30,8%). Dos que recibían carbamazepina presentaron leucopenia. Ninguno tuvo elevación de enzimas hepáticas. Los niveles séricos de los anticonvulsivantes en la mayoría se hallaron dentro del rango terapéutico. Discusión y conclusiones: Se describieron múltiples combinaciones de anticonvulsivantes con antipsicóticos y/o antidepresivos sin documentar toxicidad hepática, ni alteraciones hematológicas graves que indiquen cambio de terapia; la mayoría de los niveles séricos de anticonvulsivantes estaban dentro del rango terapéutico.

Objective: Identify drug interactions of old antiepileptic drugs with antidepressants and antipsychotics and its impact on the patient with epilepsy at the Hospital de San José in outpatient appointment from June 1 st, 2015 to the april 30th, 2016. Material and methods: A descriptive study was conducted to identify drugs interactions in patients diagnosed with epilepsy. The study involved patients over 18 years old with a diagnosis of epilepsy according to the International League Against Epilepsy criteria in therapy with first line antiepileptic drugs associated with antipsychotic drugs or/and antidepressants, excluded pregnant women, patients with hepatic and renal impairment. The statistic analysis of qualitative variables was performed using absolute and relative frequencies. Quantitative variables were analysed using medians and interquartile ranges. Results: We included 26 patients with a median age of 49 years (IQR: 33-57), 14 were women (53.8%). The most relevant conditions on past medical history were perinatal hypoxia and brain trauma, both diagnosed on 5 patients (19.2%). The most frequently anticonvulsant monotherapy used was carbamazepine, which was prescribed on 8 patients (30.8%). Only two patients receiving carbamazepine presented leucopenia. None of the patients presented elevated liver enzymes. Anticonvulsant serum levels in most therapies were within the therapeutic range. Discussion and conclusions: We described multiple combinations of anticonvulsants with antipsychotics and/or antidepressants. No liver toxicity or serious hematologic abnormalities that could suggest a change on the therapy was documented. Furthermore, most anticonvulsants serum concentration remained within the therapeutic range.

Antiphytopathogenic activity of Psoralea glandulosa (Fabaceae) against Botrytis cinerea and Phytophthora cinnamomi.

The resinous exudate, three meroterpenes, namely bakuchiol (1), 3-hydroxybakuchiol (2), 12-hydroxyisobakuchiol (3), and one furanocoumarin, psoralen (4), were isolated from the leaves of culen (Psoralea glandulosa). In addition to these, two semi-synthetic derivatives, bakuchiol acetate (5) and bakuchiol methyl eter (6), were obtained from 1, and were subsequently evaluated in vitro for the inhibitory effect of resin and compounds on the mycelial growth of Botrytis cinerea Pers.: Fr. and Phytophthora cinnamomi Rands. The resinous exudate inhibited the mycelial growth of both the pathogens, while bakuchiol (1) exhibited an inhibitory effect on the mycelial growth of B. cinerea up to 94% at a concentration of 150 mg/L and psoralen (4) reduced the mycelial growth of P. cinnamomi up to 80% at a concentration of 150 mg/L. These compounds have the ability of blocking the development of mycelial growth and may be used as a potential biopesticide in the agricultural sector once the in vivo test results have been validated.

Hormonas y migraña, una aproximación clínica / Hormones and migraine - a clinical approach

La migraña es la cefalea primaria más frecuente en las mujeres y si se suman las diversas fluctuaciones hormonales en el transcurso de la vida, la prevalencia es hasta tres veces más que en los hombres. Varía según la edad sexual siendo muchas veces la menarquia el inicio de la misma, así como la presentación exclusiva o facilitada por el período menstrual, la posmenopausia o el verdadero reto, el embarazo. Cuando mujeres de diferentes edades y tipos de cefalea, consultan, es la experticia y la adecuada orientación clínica inicial las que pueden lograr un diagnóstico oportuno y acertado. La migraña es un dolor de cabeza en los servicios de urgencias, no solo por la complejidad de su manejo en las pacientes gestantes, sino por las pocas opciones terapéuticas disponibles que sean seguras más para el feto que para la madre. El médico se ve obligado a tomar decisiones terapéuticas acertadas, generando mejoría del cuadro clínico y confianza en su paciente. Abordamos entonces el dolor de cabeza migrañoso en las mujeres durante las diversas edades en que la fluctuación de hormonas sexuales genera este trastorno, desde los puntos de vista fisiopatológico, enfoque diagnóstico y principales opciones terapéuticas estudiadas hasta el momento.

Migraine is the most common primary headache in women and fluctuating hormone levels during their lifetime is a contributing factor. It is three times more common in females than males. It varies according to sexual age and many times it begins with menarche, as well as may be affected exclusively or facilitated by menstrual cycles, menopause or pregnancy, constituting the actual challenge. When women of various ages and types of headache consult, expertise ensures a timely and accurate diagnosis. Migraine is a nuisance in the emergency services, not only due to the complexity of its management in pregnant women, but for the few available therapeutic options which are safer for the unborn baby than for the mother. The physician must determine appropriate therapies, achieving improvement and gaining patient´s confidence. We approach migraine in women during different ages in which sexual hormone fluctuation is a contributing factor from a pathophysiologic and diagnostic point of view, and current major therapeutic options evaluated to date.

Synthesis and antitumor activity of diterpenylhydroquinone derivatives of natural ent-labdanes.

Two new compounds 2ß-acetoxy-15-phenyl-(22,25-acetoxy)-ent-labda-8(17), 13(E)-diene (9) and 2ß-hydroxy-15-phenyl-(22,24,26-trimethoxy)-ent-labda-8(17),13(E)-diene (10) have been prepared by an Electrophilic Aromatic Substitution (EAS) reaction between diterpenyl allylic alcohols and 1,4-hydroquinone or 1,3,5-trimethoxybenzene using BF(3).Et(2)O as a catalyst. These compounds, along with a series of natural ent-labdanes 3-8, have been evaluated for their in vitro cytotoxic activities against cultured human cancer cells of PC-3 and DU-145 human prostate cancer, MCF-7 and MDA-MB-231 breast carcinoma and dermal human fibroblasts (DHF). Some compounds displayed inhibition at µM IC(50 )values.

Synthesis of two new hemisynthetic diterpenylhydroquinones from natural ent-labdanes.

The synthesis and structural determination of two new diterpenylhydroquinones: 2beta-acetoxy-15-phenyl-(22,25-dihydroxy)-ent-labda-8(17),13(E)-diene(1) and 2beta-hydroxy-15-phenyl-(22,25-dihydroxy)-ent-labda-8(17),13(E)-dieneis reported (2). These compounds were obtained by coupling via Electrophilic Aromatic Substitution (EAS) of 1,4-hydroquinone with primary or tertiary allyl alcohol derivatives of the natural ent-labdanes 3 and 4. With this new method, the best results were observed when mixtures of the primary alcohol derivatives 5-6 (26% yield of compound 1) and diol derivatives 9-10 (28% yield of compound 2) were used.

Oxidative degradations of the side chain of unsaturated ent-labdanes. Part I.

A selective route for the degradation of the unsaturated side chain of ent-labdanes has been devised, giving two useful synthons: 2beta-acetoxy-14,15,17-trinor-ent-labdane-8,13- dione (5) and 2beta-acetoxy-14,15-dinor-ent-labd-8(17)-en-13-one (7), the use of which for the preparation of terpenylquinone derivatives shall be reported elsewhere.

Oxidative degradations of the side chain of unsaturated ent-labdanes. Part II.

A route for the degradation of the side chain of ent-labdane derivatives has been devised, giving the useful synthon 2beta,12-dihydroxy-13,14,15,16,17-pentanor-ent-labdane-8-one (8). The use of this compound in the preparation of terpenylquinone derivatives shall be reported elsewhere. In addition we have synthesized the compound 2beta,12-diacetoxy-8beta,17-epoxy-13,14,15,16-tetranor-ent-labdane (10), which upon catalytic epoxide ring opening in alkaline or acid media gave rise in all cases to the formation of tricyclicc ompounds.