Perioperative latex hypersensitivity reactions: an integrative literature review

This article characterizes hypersensitivity reactions during anesthetic-surgical procedures. This integrative literature review was conducted in the LILACS, CINAHL, COCHRANE and MEDLINE databases including papers published from 1966 to September 2011. A total of 17 case reports, two prevalence studies and one cohort study were identified. Latex reactions were mainly type III and the primary source of intraoperative reaction was latex gloves. The average time for clinical manifestation was 59.8 minutes after anesthetic induction; 44.4% of patients reported a reaction to latex at the pre-anesthetic evaluation. It was determined that the history of allergic reactions to latex obtained in the pre-anesthetic evaluation does not ensure the safety of patients if the staff is inattentive to the severity of the issue. There is also a tendency to initially attribute the anaphylactic event to the anesthetic drugs.

Prevention of skin reactions due to teletherapy in women with breast cancer: a comprehensive review

One of the possible courses of cancer treatment is teletherapy, and one of the most important adverse side effects are skin reactions, an ailment more commonly called radiodermatitis. The main purpose of this study is to analyze knowledge of the evidence about topical products used in the prevention of radiodermatitis, to support care delivery to women with breast cancer during teletherapy. The research method used here is the comprehensive literature review. Four databases were used to select the bibliography. The sample consists of 15 articles. The data shows that, among the topical products analyzed here, Calendula, corticosteroids and Xclair have shown significant protective effects, underlining their actions. The lack of articles published in Brazil highlights the need for further research in this area, seeking better care quality through the use of products with scientifically proven efficiency.

Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy

Antibiotics are used extensively in the treatment of various infections. Consequently, they can be considered among the most important agents involved in adverse reactions to drugs, including both allergic and non-allergic drug hypersensitivity [J Allergy Clin Immunol 113:832–836, 2004]. Most studies published to date deal mainly with reactions to the beta-lactam group, and information on hypersensitivity to each of the other antimicrobial agents is scarce. The present document has been produced by the Special Committee on Drug Allergy of the World Allergy Organization to present the most relevant information on the incidence, clinical manifestations, diagnosis, possible mechanisms, and management of hypersensitivity reactions to non beta-lactam antimicrobials for use by practitioners worldwide.

(18O,16O) Two-neutron transfer reactions for spectroscopic studies.

A systematic study of the response of different nuclei to the (18O, 16O) two-neutron transfer reaction at 84 MeV incident energy was pursued at the INFN-LNS in Catania (Italy). The experiments were performed using several solid targets from light (9Bc, 11 B, 12,13C, 16O, 28Si) to heavier ones (58,64Ni, 120Sn, 208Pb). The 16O ejectiles were detected at forward angles by the MAGNEX magnetic spectrometer and identified without the need of time of flight measurements. Exploiting the large momentum (≈ 25%) and angular (50 msr) acceptance of the spectrometer, energy spectra were obtained with a relevant yield up to about 20 MeV excitation energy. A common feature of the light nuclei spectra is the strong population of states with well known configuration of two-particle over a core and the appearance of unknown resonant structures in the continuum. These latter can reveal the excitation of a collective mode connected with the transfer of a pair. For the heavier nuclei as 66Ni a completely different behaviour is observed indicating the presence of more dissipative processes in the reaction mechanisms that hide the spectroscopic information.

Study of reactions induced by 6He on 9Be

We present the results of experiments using a 6He beam on a 9Be target at energies 7 − 9 times the Coulomb barrier. Angular distributions of the elastic, inelastic scattering (target breakup) and the -particle production in the 6He+9Be collision have been analysed. Total reaction cross sections were obtained from the elastic scattering analyses and a considerable enhancement has been observed by comparing to stable systems.

Organocatalytic asymmetric mannich-type reactions: an easy approach to optically active amine derivatives

The topics I came across during the period I spent as a Ph.D. student are mainly two. The first concerns new organocatalytic protocols for Mannich-type reactions mediated by Cinchona alkaloids derivatives (Scheme I, left); the second topic, instead, regards the study of a new approach towards the enantioselective total synthesis of Aspirochlorine, a potent gliotoxin that recent studies indicate as a highly selective and active agent against fungi (Scheme I, right). At the beginning of 2005 I had the chance to join the group of Prof. Alfredo Ricci at the Department of Organic Chemistry of the University of Bologna, starting my PhD studies. During the first period I started to study a new homogeneous organocatalytic aza-Henry reaction by means of Cinchona alkaloid derivatives as chiral base catalysts with good results. Soon after we introduced a new protocol which allowed the in situ synthesis of N-carbamoyl imines, scarcely stable, moisture sensitive compounds. For this purpose we used α-amido sulfones, bench stable white crystalline solids, as imine precursors (Scheme II). In particular we were able to obtain the aza-Henry adducts, by using chiral phase transfer catalysis, with a broad range of substituents as R-group and excellent results, unprecedented for Mannich-type transformations (Scheme II). With the optimised protocol in hand we have extended the methodology to the other Mannich-type reactions. We applied the new method to the Mannich, Strecker and Pudovik (hydrophosphonylation of imines) reactions with very good results in terms of enantioselections and yields, broadening the usefulness of this novel protocol. The Mannich reaction was certainly the most extensively studied work in this thesis (Scheme III). Initially we developed the reaction with α-amido sulfones as imine precursors and non-commercially available malonates with excellent results in terms of yields and enantioselections.3 In this particular case we recorded 1 mol% of catalyst loading, very low for organocatalytic processes. Then we thought to develop a new Mannich reaction by using simpler malonates, such as dimethyl malonate.4 With new optimised condition the reaction provided slightly lower enantioselections than the previous protocol, but the Mannich adducts were very versatile for the obtainment of β3-amino acids. Furthermore we performed the first addition of cyclic β-ketoester to α-amido sulfones obtaining the corresponding products in good yield with high level of diastereomeric and enantiomeric excess (Scheme III). Further studies were done about the Strecker reaction mediated by Cinchona alkaloid phase-transfer quaternary ammonium salt derivatives, using acetone cyanohydrin, a relatively harmless cyanide source (Scheme IV). The reaction proceeded very well providing the corresponding α-amino nitriles in good yields and enantiomeric excesses. Finally, we developed two new complementary methodologies for the hydrophosphonylation of imines (Scheme V). As a result of the low stability of the products derived from aromatic imines, we performed the reactions in mild homogeneous basic condition by using quinine as a chiral base catalyst giving the α-aryl-α-amido phosphonic acid esters as products (Scheme V, top).6 On the other hand, we performed the addition of dialkyl phosphite to aliphatic imines by using chiral Cinchona alkaloid phase transfer quaternary ammonium salt derivatives using our methodology based on α-amido sulfones (Scheme V, bottom). The results were good for both procedures covering a broad range of α-amino phosphonic acid ester. During the second year Ph.D. studies, I spent six months in the group of Prof. Steven V. Ley, at the Department of Chemistry of the University of Cambridge, in United Kingdom. During this fruitful period I have been involved in a project concerning the enantioselective synthesis of Aspirochlorine. We provided a new route for the synthesis of a key intermediate, reducing the number of steps and increasing the overall yield. Then we introduced a new enantioselective spirocyclisation for the synthesis of a chiral building block for the completion of the synthesis (Scheme VI).

Competition between evaporation and fragmentation in nuclear reactions at 15-20 AMeV beam energy

The reactions 32S+58,64Ni are studied at 14.5 AMeV. From this energy on, fragmentation begins to be a dominant process, although evaporation and fission are still present. After a selection of the collision mechanism, we show that important even-odd effects are present in the isotopic fragment distributions when the excitation energy is small. The staggering effect appears to be a universal feature of fragment production, slightly enhanced when the emission source is neutron poor. A closer look at the behavior of isotopic chains reveals that odd-even effects cannot be explained by pairing effects in the nuclear mass alone, but depend in a more complex way on the de-excitation chain.

Organocatalytic tandem reactions of polyfunctional compounds for the synthesis of enantioenriched heterocycles. Reazioni tandem organocatalitiche di composti polifunzionali per la sintesi di eterocicli enantioarricchiti.

In questo lavoro di tesi sono state sviluppate reazioni domino, tandem e procedure one-pot per ottenere eterocicli enatioarricchiti. Lo sviluppo di queste metodologie sintetiche è molto importante perché permettono di ottenere molecole complesse partendo da prodotti semplici, senza effettuare ripetuti passaggi di purificazione (stop-and-go or step-by-step synthesis). Lo scopo di questo lavoro è di ottenere derivati tetraidrofuranici modificati e derivati ossoazzolinici enantioarrichiti tramite reazioni SN2-Michael o tramite reazioni aldolica-ciclizzazione-Michael usando la catalisi asimmetrica a trasferimento di fase (PTC). Come catalizzatori PTC per imprimere enantioselezione sono stati utilizzati sali di ammonio quaternario derivati dagli alcaloidi della Cinchona. Sono state ottimizzate le condizioni di reazione (base inorganica, temperatura, solvente, tempo di reazione) per i diversi substrati presi in considerazione. I prodotti target sono stati ottenuti con buone rese, ottime diastereoselezioni ma con bassa enantioselezione. I risultati ottenuti richiedono un’ulteriore ottimizzazione e dovranno essere valutate variazioni strutturali dei nucleofili utilizzati. In this thesis were developed domino, tandem reactions and one-pot procedures to obtained enantioenriched heterocycles. The development of these methodologies is very fundamental because they allow to obtain complex molecules starting from raw materials, without carrying out repeated purification steps (stop-and-go or step-by-step synthesis). The purpose of this work is to obtain enantioenriched tetrahydrofuran and oxazoline derivatives through a SN2-Michael reaction or a aldol- cyclization-Michael reaction using the phase-transfer asymmetric catalysis (PTC). For imprint enantioselection we used Cinchona alkaloids quaternary ammonium salts derivatives. The reaction conditions (inorganic base, temperature, solvent, reaction time) were optimised for the different substrates taken into account. The target products were obtained with good yields, excellent diastereoselections but with low enantioselections. The obtained results require further optimization and structural changes in the nucleophiles used must be evaluated.

Study of electromagnetic reactions on light nuclei with the Lorentz Integral Transform method

In dieser Arbeit aus dem Bereich der Wenig-Nukleonen-Physik wird die neu entwickelte Methode der Lorentz Integral Transformation (LIT) auf die Untersuchung von Kernphotoabsorption und Elektronenstreuung an leichten Kernen angewendet. Die LIT-Methode ermoeglicht exakte Rechnungen durchzufuehren, ohne explizite Bestimmung der Endzustaende im Kontinuum. Das Problem wird auf die Loesung einer bindungzustandsaehnlichen Gleichung reduziert, bei der die Endzustandswechselwirkung vollstaendig beruecksichtigt wird. Die Loesung der LIT-Gleichung wird mit Hilfe einer Entwicklung nach hypersphaerischen harmonischen Funktionen durchgefuehrt, deren Konvergenz durch Anwendung einer effektiven Wechselwirkung im Rahmem des hypersphaerischen Formalismus (EIHH) beschleunigt wird. In dieser Arbeit wird die erste mikroskopische Berechnung des totalen Wirkungsquerschnittes fuer Photoabsorption unterhalb der Pionproduktionsschwelle an 6Li, 6He und 7Li vorgestellt. Die Rechnungen werden mit zentralen semirealistischen NN-Wechselwirkungen durchgefuehrt, die die Tensor Kraft teilweise simulieren, da die Bindungsenergien von Deuteron und von Drei-Teilchen-Kernen richtig reproduziert werden. Der Wirkungsquerschnitt fur Photoabsorption an 6Li zeigt nur eine Dipol-Riesenresonanz, waehrend 6He zwei unterschiedliche Piks aufweist, die dem Aufbruch vom Halo und vom Alpha-Core entsprechen. Der Vergleich mit experimentellen Daten zeigt, dass die Addition einer P-Wellen-Wechselwirkung die Uebereinstimmung wesentlich verbessert. Bei 7Li wird nur eine Dipol-Riesenresonanz gefunden, die gut mit den verfuegbaren experimentellen Daten uebereinstimmt. Bezueglich der Elektronenstreuung wird die Berechnung der longitudinalen und transversalen Antwortfunktionen von 4He im quasi-elastischen Bereich fuer mittlere Werte des Impulsuebertrages dargestellt. Fuer die Ladungs- und Stromoperatoren wird ein nichtrelativistisches Modell verwendet. Die Rechnungen sind mit semirealistischen Wechselwirkungen durchgefuert und ein eichinvarianter Strom wird durch die Einfuehrung eines Mesonaustauschstroms gewonnen. Die Wirkung des Zweiteilchenstroms auf die transversalen Antwortfunktionen wird untersucht. Vorlaeufige Ergebnisse werden gezeigt und mit den verfuegbaren experimentellen Daten verglichen.

Kinetic and affinity analysis of hybridization reactions between PNA probes and DNA targets using surface plasmon field-enhanced fluorescence spectroscopy (SPFS)

Sequenz spezifische biomolekulare Analyseverfahren erweisen sich gerade im Hinblick auf das Humane Genom Projekt als äußerst nützlich in der Detektion von einzelnen Nukleotid Polymorphismen (SNPs) und zur Identifizierung von Genen. Auf Grund der hohen Anzahl von Basenpaaren, die zu analysieren sind, werden sensitive und effiziente Rastermethoden benötigt, welche dazu fähig sind, DNA-Proben in einer geeigneten Art und Weise zu bearbeiten. Die meisten Detektionsarten berücksichtigen die Interaktion einer verankerten Probe und des korrespondierenden Targets mit den Oberflächen. Die Analyse des kinetischen Verhaltens der Oligonukleotide auf der Sensoroberfläche ist infolgedessen von höchster Wichtigkeit für die Verbesserung bereits bekannter Detektions - Schemata. In letzter Zeit wurde die Oberflächen Plasmonen feld-verstärkte Fluoreszenz Spektroskopie (SPFS) entwickelt. Sie stellt eine kinetische Analyse - und Detektions - Methode dar, die mit doppelter Aufzeichnung, d.h. der Änderung der Reflektivität und des Fluoreszenzsignals, für das Interphasen Phänomen operiert. Durch die Verwendung von SPFS können Kinetikmessungen für die Hybridisierung zwischen Peptid Nukleinsäure (PNA), welche eine synthetisierte Nukleinsäure DNA imitiert und eine stabilere Doppelhelix formt, und DNA auf der Sensoroberfläche ausgeführt werden. Mittels einzel-, umfassend-, und titrations- Experimenten sowohl mit einer komplementär zusammenpassenden Sequenz als auch einer mismatch Sequenz können basierend auf dem Langmuir Modell die Geschwindigkeitskonstanten für die Bindungsreaktion des oligomer DNA Targets bzw. des PCR Targets zur PNA ermittelt werden. Darüber hinaus wurden die Einflüsse der Ionenstärke und der Temperatur für die PNA/DNA Hybridisierung in einer kinetischen Analyse aufgezeigt.

Towards a Reconstruction of Thermal Properties of Light Nuclei from Fusion - Evaporation reactions

This thesis work has been developed in the framework of a new experimental campaign, proposed by the NUCL-EX Collaboration (INFN III Group), in order to progress in the understanding of the statistical properties of light nuclei, at excitation energies above particle emission threshold, by measuring exclusive data from fusion-evaporation reactions. The determination of the nuclear level density in the A~20 region, the understanding of the statistical behavior of light nuclei with excitation energies ~3 A.MeV, and the measurement of observables linked to the presence of cluster structures of nuclear excited levels are the main physics goals of this work. On the theory side, the contribution to this project given by this work lies in the development of a dedicated Monte-Carlo Hauser-Feshbach code for the evaporation of the compound nucleus. The experimental part of this thesis has consisted in the participation to the measurement 12C+12C at 95 MeV beam energy, at Laboratori Nazionali di Legnaro - INFN, using the GARFIELD+Ring Counter(RCo) set-up, from the beam-time request to the data taking, data reduction, detector calibrations and data analysis. Different results of the data analysis are presented in this thesis, together with a theoretical study of the system, performed with the new statistical decay code. As a result of this work, constraints on the nuclear level density at high excitation energy for light systems ranging from C up to Mg are given. Moreover, pre-equilibrium effects, tentatively interpreted as alpha-clustering effects, are put in evidence, both in the entrance channel of the reaction and in the dissipative dynamics on the path towards thermalisation.

Development of Organocatalytic stereoselective SN1 type reactions

The proposal in my thesis has been the study of Stereoselective α-alkylation through SN1 type reaction. SN1 type reaction involves a stabilized and reactive carbocation intermediate By taking advantages of stability of particular carbocations, the use of carbocations in selective reactions has been important. In this work has been necessary to know the stability and reactivity of carbocations. And the work of Mayr group has helped to rationalize the behaviour and reactivity between the carbocations and nucleophiles by the use of Mayr’s scale of reactivity. The use of alcohols to performed the stable and reactive carbocations have been the key in my thesis. The direct nucleophilic substitution of alcohols has been a crucial scope in the field of organic synthesis, because offer a wide range of intermediates for the synthesis of natural products and pharmaceutics synthesis. In particular the catalytic nucleophilic direct substitution of alcohols represents a novel methodology for the preparation of a variety of derivatives, and water only as the sub-product in the reaction. The stereochemical control of the transformation C-H bond into stereogenic C-C bond adjacent to carbonyl functionalized has been studied for asymmetric catalysis. And the field of organocatalysis has introduced the use of small organic molecule as catalyst for stereoselective transformations. Merging these two concepts Organocatalysis and Mayr’s scale, my thesis has developed a new approach for the α-alkylation of aldehydes and ketones through SN1 type reaction.

Modeling of complex chemical reactions and macromolecular orientation phenomena in confined geometries

The cooperative motion algorithm was applied on the molecular simulation of complex chemical reactions and macromolecular orientation phenomena in confined geometries. First, we investigated the case of equilibrium step-growth polymerization in lamellae, pores and droplets. In such systems, confinement was quantified as the area/volume ratio. Results showed that, as confinement increases, polymerization becomes slower and the average molecular weight (MW) at equilibrium decreases. This is caused by the sterical hindrance imposed by the walls since chain growth reactions in their close vicinity have less realization possibilities. For reactions inside droplets at surfaces, contact angles usually increased after polymerization to compensate conformation restrictions imposed by confinement upon growing chains. In a second investigation, we considered monodisperse and chemically inert chains and focused on the effect of confinement on chain orientation. Simulations of thin polymer films showed that chains are preferably oriented parallel to the surface. Orientation increases as MW increases or as film thickness d decreases, in qualitative agreement with experiments with low MW polystyrene. It is demonstrated that the orientation of simulated chains results from a size effect, being a function of the ratio between chain end-to-end distance and d. This study was complemented by experiments with thin films of pi-conjugated polymers like MEH-PPV. Anisotropic refractive index measurements were used to analyze chain orientation. With increasing MW, orientation is enhanced. However, for MEH-PPV, orientation does not depend on d even at thicknesses much larger than the chain contour length. This contradiction with simulations was discussed by considering additional causes for orientation, for instance the appearance of nematic-like ordering in polymer films. In another investigation, we simulated droplet evaporation at soluble surfaces and reproduced the formation of wells surrounded by ringlike deposits at the surface, as observed experimentally. In our simulations, swollen substrate particles migrate to the border of the droplet to minimize the contact between solvent and vacuum, which costs the most energy. Deposit formation in the beginning of evaporation results in pinning of the droplet. When polymer chains at the substrate surface have strong uniaxial orientation, the resulting pattern is no longer similar to a ring but to a pair of half-moons. In a final stage, as an extension for the model developed for polymerization in nanoreactors, we studied the effect of geometrical confinement on a hypothetical oscillating reaction following the mechanism of the so called periodically forced Brusselator. It was shown that a reaction which is chaotic in the bulk may be driven to periodicity by confinement and vice-versa, opening new perspectives for chaos control.