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The stereochemistry of the condensations of 2-cyclohexenones, alpha-arylidenecyclohexanones, and alpha-(tert-butyldimethylsiloxy)cyclohexanones carrying one or two (both syn and anti) spirotetrahydrofuran units adjacent to the carbonyl with allyl organometallics (especially indium) and with the Normant reagent (ClMgO(CH(2))(3)MgCl) is described. Good levels of anti stereoselection are observed in the alpha-arylidene series. Subsequent cyclization generates a second (or third) tetrahydrofuran ring possessing trans vicinal oxygens. Useful levels of matched and mismatched diastereoselection are also attainable by prior alpha-oxygenation. The intrinsic differences in diastereomer production between indium and magnesium organometallics are highlighted. A clear distinction regarding the anticipated direction of stereoselectivity is made on the grounds of chelation capabilities and the intra- or intermolecularity of carbon-carbon bond formation. Finally, the two protocols that are described in detail are shown to be iterative, a feature that augurs well for ultimately accessing the eight possible hexaspirocyclohexanes in an efficient and stereocontrolled manner.
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http://dx.doi.org/10.1021/jo960962h | DOI Listing |
Arq Bras Cir Dig
September 2025
Universidade de São Paulo, Faculty of Medicine, Department of Gastroenterology, Colonoscopy Division - São Paulo (SP), Brazil.
Background: Artificial intelligence (AI)-assisted colonoscopy has emerged as a tool to enhance adenoma detection rates (ADRs) and improve lesion characterization. However, its performance in real-world settings, especially in developing countries, remains uncertain.
Aims: The aim of this study was to evaluate the impact of AI on ADRs and its concordance with histopathological diagnosis.
PLoS One
September 2025
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil.
Background: Reinfections with SARS-CoV-2 have gained increasing relevance in the context of emerging immune-evasive variants and waning population immunity. Understanding their frequency and distribution is essential to guide public health strategies, particularly in middle-income countries. This study investigates the epidemiological patterns of SARS-CoV-2 reinfections in Espírito Santo, Brazil, using integrated notification and vaccination databases.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
September 2025
Infection Prevention and Control, Children's Health System of Texas, Dallas, TX, USA.
Background: The utility of routine environmental sampling to monitor the airborne fungal load (AFL) in healthcare settings is uncertain.
Methods: AFL was measured by monthly cultures at a tertiary-care pediatric hospital from November 2018 through October 2023 on eleven units caring for patients at risk for invasive mold infection (IMI). Surveillance for healthcare-associated IMI was conducted for all patients in the healthcare system using locally developed definitions for possible, probable, and definite hospital-onset infections.
Infect Control Hosp Epidemiol
September 2025
Department of Medicine, University Health Network, Toronto, Ontario, Canada.
Objective: To describe trends in the prevalence of healthcare-associated infections (HAIs) and antibiotic-resistant organisms (AROs) in Canadian acute-care hospitals.
Design: Repeated point prevalence surveys.
Setting: Canadian Nosocomial Infection Surveillance Program (CNISP) hospitals.
Eur J Case Rep Intern Med
July 2025
Intensive care unit, Clinical Hospital Sveti Duh, Zagreb, Croatia.
Background: Tacrolimus is a commonly used immunosuppressant with well-defined side effects, including hypertriglyceridemia and hyperglycaemia. However, acute pancreatitis is still not widely recognized as an adverse event related to tacrolimus.
Case Presentation: A 60-year-old male was admitted to the intensive care unit with symptoms and signs of acute pancreatitis.