Systemic hypersensitivity reaction to endovascular stainless steel stent.

Endovascular intervention has become the mainstay for treatment of most patients suffering from peripheral vascular disease. We describe a patient with a known nickel allergy who underwent placement of a stainless steel stent for aortoiliac occlusive disease. Despite our attempt to avoid a nickel-containing stent, the patient developed a diffuse rash consistent with a nickel or metal allergy. A review of stainless steel metallurgy revealed that nickel, cobalt, and titanium are frequently used to provide anticorrosive properties to stainless steel. The clinical significance of the use of nickel-alloy stents in the setting of patients with a nickel allergy is discussed.

Quality of diabetes mellitus care by rural primary care physicians.

PURPOSE: To explore the relationship between degree of rurality and glucose (hemoglobin A1c), blood pressure (BP), and lipid (LDL) control among patients with diabetes. METHODS: Descriptive study; 1,649 patients in 205 rural practices in the United States. Patients' residence ZIP codes defined degree of rurality (Rural-Urban Commuting Areas codes). Outcomes were measures of acceptable control (A1c < = 9%, BP < 140/90 mmHg, LDL < 130 mg/dL) and optimal control (A1c < 7%, BP < 130/80 mmHg, LDL < 100 mg/dL). Statistical significance was set at P < .008 (Bonferroni's correction). FINDINGS: Although the proportion of patients with reasonable A1c control worsened by increasing degree of rurality, the differences were not statistically significant (urban 90%, large rural 88%, small rural 85%, isolated rural 83%; P = .10); mean A1c values also increased by degree of rurality, although not statistically significant (urban 7.2 [SD 1.6], large rural 7.3 [SD 1.7], small rural 7.5 [SD 1.8], isolated rural 7.5 [SD 1.9]; P = .16). We observed no differences between degree of rural and reasonable BP or LDL control (P = .42, P = .23, respectively) or optimal A1c or BP control (P = .52, P = .65, respectively). Optimal and mean LDL values worsened as rurality increased (P = .08, P = .029, respectively). CONCLUSIONS: In patients with diabetes who seek care in the rural Southern United States, we observed no relationship between degree of rurality of patients' residence and traditional measures of quality of care. Further examination of the trends and explanatory factors for relative worsening of metabolic control by increasing degree of rurality is warranted.

Regioselective synthesis of asymmetrically substituted 2-quinoxalinol salen ligands.

Diamino-2-quinoxalinols are reacted with salicylaldehyde derivatives to produce 2-quinoxalinol imines regioselectively as one isomer in good yield. Regioselectivity has been determined through the use of isotopic 15N labeling experiments. The 2-quinoxalinol imines may then be reacted without further purification with additional salicylaldehyde derivatives to yield asymmetrically substituted 2-quinoxalinol salens.

Uranyl stabilized Schiff base complex.

Uranyl Schiff base complex [(UO(2))(2)(Salpro)(OH)(Solvent)(2)] (1) in the presence of excess of ethylenediamine (EDA) does not undergo nucleophilic addition (hydrolysis) and substitution (transamination) reactions due to an extended chelation [2N, 3O + OH] by the flexible backbone.