Cr(Salen)-catalyzed addition of 1,3-dichloropropene to aromatic aldehydes. A simple access to optically active vinyl epoxides.

[reaction: see text]. Chiral Cr(Salen) complex (1) prepared in situ from CrCl3 promotes the enantioselective addition of 1,3-dichloropropene to aromatic aldehydes in the presence of Mn as the stoichiometric reductant and Me3SiCl as a scavenger. The resulting 1,2-chlorohydrins obtained in good enantiomeric and diastereoisomeric excesses can be easily transformed into the corresponding chiral vinyl epoxides.

Synthesis and binding activity of endomorphin-1 analogues containing beta-amino acids.

Endomorphin-1 (Tyr-Pro-Trp-PheNH2) has been proposed as the most potent endogenous ligand of the mu-opioid receptors. In this paper, we describe the synthesis of some endomorphin-1 based tetrapeptides in which a residue of the sequence Tyr-Pro-Trp-PheNH2 is replaced by the corresponding beta-isomer. These novel peptides showed different affinities for the opioid receptors labeled with [3H]-DAMGO in rat brain membranes, depending on the beta-amino acid. In particular, the tetrapeptide containing beta-Pro (Tyr-beta-(R)-Pro-Trp-PheNH2) displayed a higher affinity than endogenous endomorphin-1, as revealed by their Ki values (0.33 and 11.1 nM, respectively).

The First Catalytic Enantioselective Nozaki-Hiyama Reaction.

The Nozaki-Hiyama reaction can be performed in an enantioselective catalytic way! The catalytic system utilizes 10 mol % of an inexpensive chiral [Cr(salen)] complex. The [Cr(salen)]/Mn/Me(3)SiCl system effectively promotes the enantioselective addition of allyl chloride to aliphatic and aromatic aldehydes at room temperature (65-89 % ee, 40-60 % yield).

Acute hospitalization and discharge outcome of neurologically intact trauma patients sustaining thoracolumbar vertebral fractures managed conservatively with thoracolumbosacral orthoses and physical therapy.

OBJECTIVES: To identify the acute hospital discharge functional status achieved and the amount of physical therapy (PT) and occupational therapy (OT) received by neurologically intact patients with thoracolumbar vertebral fractures managed only by bracing with a custom-molded thoracolumbosacral orthosis (TLSO). These patients would be expected to ambulate independently soon after receiving their TLSOs unless they had concomitant lower extremity injuries, but they may need assistance with lower extremity activities of daily living. DESIGN: Retrospective study. SETTING: Urban, level I trauma center. PATIENTS: Twenty-seven subjects who sustained one or more thoracolumbar fractures, were neurologically intact, and were managed nonoperatively with a custom-molded TLSO. OUTCOME MEASURES: Median time to TLSO arrival, start of PT, number of PT sessions, time to ambulate independently from admission, and length of stay (LOS). RESULTS: Median time to TLSO arrival was 2 days, start of PT was 4 days, number of PT sessions was one, time to ambulate independently from admission was 3(1/2) days, and LOS was 5 days. Subjects with lower extremity fractures required significantly (p < .037) more PT sessions to achieve independent ambulation than those without lower extremity fractures. Almost 89% of the subjects ambulated independently with or without an assistive device at discharge. Fifty-nine percent of subjects were discharged home the day they cleared PT for independent ambulation. Only 11% of the subjects received OT. CONCLUSIONS: A majority of neurologically intact patients with thoracolumbar fractures managed conservatively with a TLSO ambulate independently after receiving one or two sessions of PT and can be discharged home on the same day of PT clearance. Patients with lower-extremity fractures need more PT to achieve independent ambulation. The consequences of a minority of these patients being evaluated and seen by OT are not fully known. Future research may be able to document the need for more OT services.

Status of physiatry and physical medicine and rehabilitation departments in adult level I trauma centers.

OBJECTIVE: To determine the involvement of physiatrists and physical medicine and rehabilitation (PM&R) departments in the acute care of patients admitted to level I trauma centers. DESIGN: An 18-question survey. SETTING: Adult, level I trauma center. PARTICIPANTS: Physiatrists, administrative directors, and others involved in rehabilitation in their respective trauma centers. Surveys were mailed to 164 PM&R departments in level I trauma centers. One hundred sixteen responses (70.7%) were received. One hundred five responses (64.0% of total) were used. MAIN OUTCOME MEASURES: The 18-item questionnaire covered topics such as number of staff (based at the trauma center) and consulting physiatrists, number of residents, rehabilitation personnel shortages, participation in multidisciplinary patient care rounds, and relationships between the trauma and rehabilitation services. RESULTS: Eighty-five percent of respondents have at least one full-time or part-time physiatrist based in their PM&R departments. Physiatrists consult in 91% of the responding level I trauma centers. Residents rotate through 52% of responding PM&R departments. Forty-four percent of respondents reported staff shortages, with occupational therapy in greatest demand. Seventy-six percent of PM&R departments participate in multidisciplinary rounds with the trauma service. Eighty-nine percent of PM&R departments stated their relationship with the trauma service was excellent or good. CONCLUSION: Physiatrists and other allied health personnel are integral members of the trauma care team in most level I trauma centers participating in this study. Further expansion should be encouraged to facilitate early and comprehensive rehabilitative care in all level I centers.

Hospitalization and discharge outcome of trauma patients sustaining sciatic nerve or sciatic branch injuries.

This study determined the number and severity of injuries, surgeries, and/or other complications and their impact on the acute hospital course of a series of 15 patients sustaining unilateral traumatic sciatic nerve or sciatic branch injuries. Outcome measures studied were length of stay, time to ambulate independently from admission, starting time for physical therapy, and number of physical therapy sessions. Median length of stay (LOS) and time to independent ambulation with assistive devices from admission were 12 and 8 days, respectively. Seven patients required fasciotomy, five required vascular repair, and five sustained fractures of the involved limb. Patients needing a fasciotomy had a significantly longer LOS (P < 0.002) and time to ambulate independently (P < 0.001), started physical therapy later (P < 0.006), and required more therapy sessions (P < 0.007) before independent ambulation was achieved. Patients with a vascular repair had a significantly longer LOS (P < 0.049) and time to ambulate independently (P < 0.012). These patients trended toward starting physical therapy later (P < 0.063) and requiring more therapy sessions (P < 0.109) before independent ambulation was achieved. The presence of a fracture in the involved limb did not affect outcome variables. The level and severity of nerve injuries were variable; therefore, their effects on LOS and ambulation could not be determined. These findings suggest that fasciotomies and vascular repairs but not fractures adversely affect the acute LOS, time to ambulate independently, start of physical therapy, and number of physical therapy sessions in trauma patients with sciatic nerve or sciatic branch injury. This information may be useful to the consulting physiatrist.

Functional outcome and comorbidity indexes in the rehabilitation of the traumatic versus the vascular unilateral lower limb amputee.

This study compared the Functional Independence Measure (FIM) scores of traumatic (n=12) and vascular (n=12) unilateral lower limb amputees at admission and discharge from a rehabilitation facility. FIM scores that were measured were amputation FIM subscores and total FIM scores. Comorbidity indexes were developed to weight the stump condition and comorbidities seen in both groups. The vascular group was significantly (P<0.01) greater stump comorbidity, but there was no significant difference with respect to length of stay, medical comorbidity score, and amputation and total FIM scores both at admission and discharge between the two groups. Medical comorbidity was significantly (P<0.05) correlated with amputation and total FIM scores at discharge for traumatic amputees with r = -0.64 and r = -0.66, respectively. Stump comorbidity was significantly (P<0.05) correlated with total FIM at discharge with r = -0.64 for vascular amputees. Medical comorbidity was a good predictor of discharge FIM scores for traumatic amputees, whereas stump comorbidity predicted discharge FIM scores for vascular amputees, although not as well. In conclusion, inpatient traumatic amputees may be younger than vascular amputees, but traumatic amputees may not necessarily be healthier or do better functionally at discharge than vascular amputees.

Enantiomeric separation of substituted flavanoids by LC-DAD.

A variety of racemic flavanoids with anti-rhinovirus activity have been resolved for the first time by HPLC, using a chiral stationary phase. Baseline separation was easily obtained for racemic 4',6-dichloroisoflavan (V). The absolute configurations of two enantiomers (Va and Vb) were established by comparing their circular dichroism curves with those of other known isoflavans. Both the isomers were tested against human rhinovirus serotype 1B infection in vitro; the S form was approximately four times more effective than the R form.

Determination of methyl bromide traces in some food products by HS-GC/MS.

A simple and rapid method has been developed for fast selective determination of residues of methyl bromide in food products. The method is based on the use of a GC/MS computer-aided system equipped with a headspace. Analysis of methyl bromide was carried out directly on the food products without preliminary extraction of fumigant. An MSD quadrupole mass spectrometer with data processing allowed rapid identification of the separated volatile compound in the samples. The technique of focusing on characteristic single ion monitoring for quantification of methyl bromide, compared with chromatographic peak area measurement, turned out to have a good degree of accuracy and sensitivity. The use of known amount of added methyl bromide allowed better evaluation of traces of this compound. The proposed method was applied to the analysis of methyl bromide residues in alimentary pastes, white flour, rice, hazelnuts, peanuts and dried mushrooms (boletus).