The breath print represents a novel biomarker of malnutrition in pulmonary arterial hypertension: A proof of concept study.

Background: The breath print is a quantitative measurement of molecules in exhaled breath and represents a new frontier for biomarker identification. It is unknown whether this state-of-the-art, noninvasive method can detect malnutrition. We hypothesize that individuals with malnutrition will present with a distinguishable breath print.

Dietitians' Evaluation of Clearing Luminal Occlusions of Gunk (DECLOG): A Pilot Feasibility Study.

Background: Tube clogging is the most frequent mechanical complication associated with enteral nutrition. The objective of this study was to assess the efficacy of a protocol incorporating prophylactic use of a declogging system with enhanced patient education and monitoring to proactively reduce the incidence of tube occlusions in the home care setting.

Methods: A convenient sample of patients discharged from hospital to home enteral nutrition (HEN) was screened for eligibility and randomized to control group (standard care) or study group (standard care with prophylactic protocol and monitoring).

Near-infrared spectroscopy: applications in neonates.

Near-infrared spectroscopy (NIRS) offers non-invasive, in-vivo, real-time monitoring of tissue oxygenation. Changes in regional tissue oxygenation as detected by NIRS may reflect the delicate balance between oxygen delivery and consumption. Originally used predominantly to assess cerebral oxygenation and perfusion perioperatively during cardiac and neurosurgery, and following head trauma, NIRS has gained widespread popularity in many clinical settings in all age groups including neonates.

A case report of reappearance of spinal anesthesia.

Objective: We present a case of reappearance of spinal anesthesia despite the use of plain (isobaric) lidocaine and without an associated cough or Valsalva maneuver.

Case Report: A 66-year-old man had spinal anesthesia for knee arthroscopy. Two hours after the induction of spinal anesthesia and after the patient's motor strength had returned to the lower extremities, his head was elevated to 30 degrees.

Stereoselective synthesis of a potent thrombin inhibitor by a novel P2-P3 lactone ring opening.

The concise synthesis of a potent thrombin inhibitor was accomplished by a mild lactone aminolysis between an orthogonally protected bis-benzylic amine and a diastereomerically pure lactone. The lactone was synthesized by the condensation of l-proline methyl ester with an enantiomerically pure hydroxy acid, which in turn was synthesized by a highly stereoselective (>500:1 er) and productive (100,000:1, S/C) enzymatic reduction of an alpha-ketoester. In addition, a second route to the enantiomerically pure lactone was accomplished by a diastereoselective ketoamide reduction.