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OBJECTIVES: Nonsteroidal anti-inflammatory drugs (NSAIDs) contribute to the esophageal mucosal injury through its direct topical impact on the luminal aspect of the surface epithelium. Its indirect, systemic impact, however, on salivary component of the esophageal pre-epithelial barrier remains to be explored. Therefore, salivary mucin secretion and viscosity at baseline and during naproxen-placebo, as well as naproxen-rabeprazole, administration were investigated. METHODS: Twenty-one asymptomatic volunteers were included in this double-blind, placebo-controlled, crossover designed study. Salivary samples were obtained in basal and pentagastrin-stimulated conditions (6 mg/kg s.c.) mimicking the food-stimulated conditions. Patients received 7 days of naproxen-placebo or naproxen-rabeprazole with a 2-week washout period in between. Salivary mucin content and viscosity were measured before and after treatment using periodic acid/Schiff's methodology and Cone/Plate Digital Viscometer, respectively. RESULTS: The rate of salivary mucin secretion in basal condition declined by 32% during administration of naproxen-placebo (11.3±1.7 vs. 16.8±3.3 mg/h). Salivary mucin secretion in pentagastrin-stimulated condition declined significantly (by 34%) during the administration of naproxen-placebo (13.6±1.5 vs. 20.7±3.0 mg/h; P

Introduction Rifaximin is an orally administrated, nonabsorbed, nonsystemic antibiotic recently approved by the US Food and Drug Administration for traveler9s diarrhea. Its utility in eradication of small intestinal bacterial overgrowth (SIBO) is currently being evaluated. Purpose The aim of this study is to investigate efficacy and safety of rifaximin for bacterial eradication and relieving symptoms in patients affected by SIBO. Methods Treatment with rifaximin 200 mg qid was undertaken for 4 weeks. Assessment of a symptom score consisting of frequency and severity of bloating, gas, abdominal pain, and bowel movements was calculated at the beginning and after treatment. Glucose breath test (GBT) was also performed. Standard demographics were assessed. Subjects Ten consecutive symptomatic patients (8 F and 2 M, mean age of 53, range 19-85) were prospectively studied in an open-labeled fashion. Seven patients (70%) presented with diarrhea, 3 (30%) with bloating and gas as a dominant symptom. All patients had a > 20 ppm concentration of hydrogen and/or methane within 90 minutes of ingesting 50 g of glucose in 150 cc aqueous solution (GBT). Three subjects were exclusive methane formers, 1 methane and hydrogen, and 6 produced only hydrogen. Results Among patients with diarrhea 5 (71%) noticed improvement of more then 50%; 2 (29%) between 25 and 50%; 1 had no response after 4 weeks of rifaximin. Among patients with bloating + gas as the main symptom: 1 (33) had improvement between 50 and 75%; 1 (33%) between 25 and 50%, and 1 (33%) had no response. Repeat GBT in 6 patients at the end of the 4 weeks showed 50% of hydrogen formers and 67% of methane producers were eradicated. No adverse effects were observed. Conclusions This study shows that rifaximin in a dose of 200 mg qid for at least 4 weeks seems to be effective and safe treatment in reducing diarrhea and to a lesser degree gas + bloating in patients with SIBO. Further studies of follow-up breath test results and longer-term outcome are the next step in assessing this promising new therapy for SIBO.

(S)-Malic acid diethyl ester was converted into a precursor of the lactonic portion of compactin and mevinolin. The substance was coupled with benzyl p -tolyl sulfone and elaborated into the chiral lactone system of the natural products.

Deprotonation of unsaturated amides 3c - f occurs stereoselectively from the Z-γ-carbon leading, after methylation, to deconjugated products 4–6. An eight membered ring transition state model analogous to the Ireland formulation for enolization is proposed to explain these observations.

O-Silylated vinyl ketene aminal 2, obtained from lithiated unsaturated amide 1 , undergoes a thermal [1,5] silicon migration to give γ-silylated product 3b which participates in fluoride- and titanium tetrachloride-mediated aldol condensations to give adducts 5 in poor and excellent syn diastereoselectivity respectively.

Lithium diisopropylamide reduces aldehydes to the corresponding alcohols and also 0forms adducts with aldehydes. Both processes can compete with enolization.

The aldol addition reactions of the lithium enolate of cyclohexanone with aromatic aldehydes show high kinetic threo selectivity.

The spiro[3,4-dihydro-2H-1-benzopyran-2,2′-bicyclo[3.1.1]heptane] framework of natural products Robustadials was constructed in a homochiral form. The synthesis started from 1 S -(−)-β-pinene, which was coupled to a substituted benzaldehyde using a Prins reaction, and incorporated a diastereoselective, Michael-type, intramolecular addition.

We report a 16-year-old girl in whom Takayasu arteritis (TA) was manifested mainly by severe arterial hypertension on her right arm, which was detected during a routine examination at school. Her systolic blood pressure on the right arm was significantly higher than that on the left one. There was also a pressure difference between the right arm and legs. The pulse of the left external carotid artery and that of the left radial artery was absent. Vascular bruits over interscapular and right supra- and subclavian areas were heard on auscultation. The diagnosis of TA was confirmed by a spiral computed tomography angiography, which showed a thickened thoracic aortic wall and narrowing of its lumen. In addition, complete occlusion of the left common carotid artery and the left subclavian artery was observed. Conclusion: The rarity of the disorder and the heterogeneous nature of its clinical manifestation predispose to a late diagnosis and delayed treatment. Our report highlights the fact that the condition can and does occur in a pediatric population in Europe and hence must be considered in patients presenting with suggestive symptoms and signs, especially in young patients with unexplained hypertension. Clinical suspicion and proper imaging are crucial for the correct diagnosis and management of patients with TA. A brief review of literature completes this report.

Some hyperbolic and elliptic control systems are considered. Using variational and topological methods we prove sufficient conditions for the existence and stability of the optimal processes.

LDA-induced cyclization of 4 yields 5 , the trans -isomer of which undergoes dehydration using Ph 2 S[OC(CF 3 ) 2 Ph] 2 to give the pyrethroid amide 6 .

The heat of formation of t-butoxytriphenylphosphoranyl was measured using a photoacoustic technique and allowed the construction of a complete enthalpic profile for the formation of this radical.