Classification of acute and delayed contrast media-induced reactions: proposal of a three-step system

Physicians and scientists use a broad spectrum of terms to classify contrast media (CM)-induced adverse reactions. In particular, the designation of hypersensitivity reactions is quite varied. Consequently, comparisons of different papers dealing with this subject are difficult or even impossible. Moreover, general descriptions may lead to problems in understanding reactions in patients with a history of adverse CM-reactions, and in efficiently managing these patients. Therefore, the goal of this paper is to suggest an easy system to clearly classify these reactions. The proposed three-step systems (3SS) is built up as follows: step 1 exactly describes the clinical features, including their severity; step 2 categorizes the time point of the onset (immediate or nonimmediate); and step 3 generally classifies the reaction (hypersensitivity or nonhypersensitivity reaction). The 3SS may facilitate better understanding of the clinical manifestations of adverse CM reactions and may support the prevention of these reactions on the basis of personalized medicine approaches.

The Synthesis of Macrocyclic Polystyrene by Sequential Atom Transfer Radical Reactions

A method for the production of macrocyclic polystyrene via ring closing of a linear !,"-dibrominated polystyrene by an Atom Transfer Radical Coupling (ATRC) reaction is described. The dibrominated polystyrene chain was produced from two simultaneous atom transfer radical polymerizations (ATRPs) originating from a dibrominated benzal bromide initiator. To ensure the retention of the halogen end groups polymerization was allowed to proceed to less than 50% conversion. Using this precursor in an intramolecular ATRC (ring closing) reaction was found to yield in excess of 90% cyclic product based on refractive index-gel permeation chromatography (GPC) analysis. The cyclic architecture of the polymer was verified by GPC, Nuclear Magnetic Resonance (NMR), and mass spectrometry analysis. The utility of this method has been expanded by the addition of 2-methyl-2-nitrosopropane to the coupling reaction, which allows for the coupling to proceed at a faster rate and to yield macrocycles with incorporated alkoxyamine functionality. The alkoxyamine functionality allows for degradation of the cycles at high temperatures (>125° C) and we hypothesize that it may allow the macrocycles to act as a macroinitiator for a ring expansion polymerization in future studies.

Microwave-Assisted Phospha-Michael Reactions with Internal Alkenes

The atom efficient phospha-Michael reaction between bis 4-methylphenyl phosphine oxide and several activated internal alkenes has been shown to occur under microwave irradiation without added solvent or catalyst. The alkenes used for this study were ethyl 4-nitrocinnamate, two chalcones ((E)-3-(4-methoxy-phenyl)-1-(4- nitrophenyl)-prop-2-en-1-one and (E)-1-(4-methoxyphenyl)-3-(3-nitro-phenyl)-prop-2- en-1-one), and 2-phenylmethylene-propanedinitrile. In the case of ethyl 4-nitrocinnamate, reaction with bis 4-methylphenyl phosphine oxide for sixty minutes at 130 °C yielded the desired phospha-Michael product in a 55% yield after purification. Varying the location of the nitro group on the phenyl rings of the chalcones did not seem to have a large effect on their reactivity. By NMR, both chalcones seemed to react to the same extent when the reaction times and temperatures were held constant. Interestingly, a phospha-Michael reaction was observed at a reaction temperature of 65°C for experiments involving 2- phenyl-methylene-propanedinitrile while the other substrates required a reaction temperature of 130 °C. Similar experiments were carried out with bis mesityl phosphine oxide and two internal alkenes: 2-phenylmethylene-propanedinitrile and ethyl-2-cyano-3- methyl-2-butenoate. These experiments did not yield any of the predicted phospha- Michael products, which suggest steric limitations to the Michael donor for this reaction.

Improvement of interferon-beta related skin reactions after diluent halving: first experience of five patients

The spectrum of side effects related to interferon beta-1b (INF-1b) treatment may compromise long-term adherence.

Microwave-Assisted Bond Forming Reactions

ABSTRACT FOR PART I: PHOSPHA-MICHAEL ADDITIONS TO ACTIVATED INTERNAL ALKENES: STERIC AND ELECTRONIC EFFECTS A method for the phospha-Michael addition of bis(4-methyl)phenyl phosphine oxide to activated internal alkenes has been developed. Michael acceptors including cinnamates, crotonates, chalcones, and internal alkenes containing multiple activating groups were all successfully utilized in this reaction. The reaction was fairly tolerant of electron-donating and electron-withdrawing substituents on the Michael acceptor, and moderate to excellent yields (49-96%) of the adducts were isolated. When steric bulk was increased by a second substituent on the -position of the Michael-acceptor the reaction was suppressed. This was usually overcome by adding a second activating substituent to the -position. ABSTRACT FOR PART II: MICROWAVE-ASSISTED ARYLGOLD BOND FORMATION A microwave-assisted method was developed for the formation of arylgold complexes containing (2-Biphenyl)di-tert-butylphosphine (JohnPhos) as the supporting phosphine ligand. Arylboronic acids with increasingly bulky aromatic groups were screened to determine the steric limitations of the reaction. Arylgold complexes (JohnPhos)Au(p-methoxyphenyl), (JohnPhos)Au(2,4,6-trimethylphenyl), and (JohnPhos)Au(4-bromo-10-anthracene) were all synthesized by microwave irradiation at 70ºC in the presence of Cs2CO3 in either THF or iPrOH. Reactions performed with arylboronic acids containing unhindered ortho positions were carried out in THF. Arylboronic acids with substituents on the ortho position required iPrOH as the reaction solvent. Arylboronic acids with extreme steric hindrance on the ortho position of the aryl substituent, 2,4,6-triisopropylpphenylboronic acid, were unreactive. It was determined that increasing the irradiation temperature increased the formation of side products, therefore to promote conversion to the arylgold complex the duration of the reaction time was increased while maintaining a temperature of 70ºC. Arylgold complexes (JohnPhos)Au(p-methoxyphenyl), (JohnPhos)Au(2,4,6-trimethylphenyl), and (JohnPhos)Au(4-bromo-10-anthracene) were synthesized with moderate yields (40-69%).

Gold Phosphonates as Transfer Agents in Palladium Catalyzed Hirao Reactions

Through a cross-coupling reaction, aryl phosphonates are produced in high yields when the corresponding aryl bromides are reacted with a gold phosphorylating agent in the presence of a palladium catalyst and an appropriate ligand. To the best of our knowledge, this transformation is the first example involving the transfer of a phosphonate functional group from a gold complex to palladium that has been reported. Throughout the investigation, three gold phosphorylating agents were screened for activity towards the phosphorylation of aryl bromides. Aryl bromides with electrondonating and electron-withdrawing groups were successfully employed in the crosscoupling reactions. All cross-coupling reactions were carried out in THF at room temperature (25ºC) or in a microwave reactor (CEM Discover) at 60ºC for 30 or 60 minutes. The effects of changing reaction parameters such as time, temperature, catalyst and free ligand loading have been investigated. All aryl bromide substrates tested in the cross-coupling reactions produced phosphorylated products.

Potential drug-drug interactions and adverse drug reactions in patients with liver cirrhosis

Patients with liver cirrhosis may be at risk for potential drug-drug interactions (pDDIs) and/or adverse drug reactions (ADRs) due to the severity of their disease and comorbidities associated with polypharmacy.

Music, perceived arousal, and intensity: psychophysiological reactions to Chopin's "Tristesse"

The present study investigates the relation of perceived arousal (continuous self-rating), autonomic nervous system activity (heart rate, heart rate variability) and musical characteristics (sound intensity, musical rhythm) upon listening to a complex musical piece. Twenty amateur musicians listened to two performances of Chopin's "Tristesse" with different rhythmic shapes. Besides conventional statistical methods for analyzing psychophysiological reactions (heart rate, respiration rate) and musical variables, semblance analysis was used. Perceived arousal correlated strongly with sound intensity; heart rate showed only a partial response to changes in sound intensity. Larger changes in heart rate were caused by the version with more rhythmic tension. The low-/high-frequency ratio of heart rate variability increased-whereas the high frequency component decreased-during music listening. We conclude that autonomic nervous system activity can be modulated not only by sound intensity but also by the interpreter's use of rhythmic tension. Semblance analysis enables us to track the subtle correlations between musical and physiological variables.