Matthew Oswald

An efficient method for the chemoselective synthesis of acylals from aromatic aldehydes using bismuth triflate

Aromatic aldehydes are smoothly converted into the corresponding acylals in good yields in the presence of 0.10 mol% Bi(OTf)3·xH2O. Ketones are not affected under the reaction conditions. The highly catalytic nature of bismuth triflate and the fact that it is relatively non-toxic, easy to handle and insensitive to small amounts of air and moisture makes this procedure especially attractive for large-scale synthesis.

A Facile and Efficient Method for the Rearrangement of Aryl-substituted Epoxides to Aldehydes and Ketones using Bismuth Triflate

Abstract Aryl-substituted epoxides undergo smooth rearrangement in the presence of 0.01–0.1 mol% Bi(OTf) 3 · x H 2 O. The rearrangement is regioselective with aryl-substituted epoxides, and products arise from cleavage of the benzylic CO bond. The highly catalytic nature of this method coupled with the fact that the reagent is relatively non-toxic, easy to handle and inexpensive make it an attractive alternative to more corrosive and toxic Lewis acids, such as BF 3 ·Et 2 O, currently used to effect epoxide rearrangements.

The effect of protein and calorie intake on prealbumin, complications, length of stay, and function in the acute rehabilitation inpatient with stroke

BACKGROUND Nutritions impact on stroke rehabilitation outcomes is controversial. Existing studies utilize albumin without correcting for inflammation in nutritional assessments. Here, prealbumin was used and inflammation assessed to determine if nutrition impacts rehabilitation outcomes. OBJECTIVE Determine the effect of dietary intake on prealbumin level, number of complications, length of stay, and Functional Independence Measure (FIM) efficiency in rehabilitation stroke inpatients. METHODS Patients had admission and discharge prealbumin and C-reactive protein (CRP) levels drawn; and, weekly protein and calorie counts obtained. Patients were followed for number of complications, length of stay, and FIM efficiency. RESULTS Mean protein and calorie intake was 57.6 ± 16.2 g/d and 1452.2 ± 435.8 kcal/d, respectively. 77.6% of patients had normal prealbumin on admission with 94.9% on discharge. Prealbumin increased significantly from admission to discharge (22.3 ± 6.2 mg/dL vs. 24.6 mg/dL ± 5.1 mg/dL, P = 0.007). Number of complications and length of stay were predicted by CRP in regression models. Total, motor, and cognitive FIM efficiencies were not universally affected by prealbumin levels, protein intake, or calorie intake. CONCLUSIONS Nearly all hypoprealbuminemic stroke rehabilitation inpatients correct their levels eating a non-supplemented diet. Number of complications, length of stay, and functional outcomes in this patient are not affected by prealbumin levels, protein intake, or calorie intake.

Electrodiagnostics and Clinical Correlates in Acquired Polyneuropathies

Peripheral neuropathies result from a variety of inherited and acquired pathologies. They display an assortment of clinical signs and symptoms and present with a broad range of severity. Electrodiagnosis can play a key role in the evaluation of a suspected peripheral neuropathy. A peripheral nerve disorder is first suspected on the basis of history and physical examination findings. Electrodiagnosis is then used to confirm the diagnosis and to characterize the peripheral neuropathy, providing information about its distribution, pathophysiologic process (demyelinating vs axonal), and chronicity.

Outcomes of Inpatient Rehabilitation in Patients With Simultaneous Bilateral Total Knee Arthroplasty.

The number of total knee arthroplasty (TKA) procedures performed in the United States is increasing each year, and the number of bilateral TKA procedures has also increased during the past 2 decades. However, few studies in the literature have investigated the rehabilitation outcomes of patients who undergo bilateral TKA. This study was performed to provide information on the benefits and role of inpatient rehabilitation for patients after bilateral TKA.

An Appropriate Population for Acute Inpatient Rehabilitation? A Case Series of Three Patients With Advanced Heart Failure on Continuous Inotropic Support.

The number of individuals with heart failure and the treatment modalities available to manage heart failure are increasing. Continuous inotropic support is a treatment modality used in cases of severe heart failure. Although most patients initiated on continuous inotropic support are discharged home, those with greater functional compromise, comorbid conditions that cause disability, or other significant medical complexity may be referred to acute inpatient rehabilitation. The feasibility and benefits of acute inpatient rehabilitation in this population, however, has yet to be investigated. We report the functional progress and medical complications of 3 patients on continuous inotropic support who participated in acute inpatient rehabilitation. The patients demonstrated varying levels of success, highlighting a need for evidence‐based, preadmission screening criteria for this population.

Poster 438: Hypoprealbuminemia in the Acute Inpatient Rehabilitation Stroke Patient and Its Effect on Function and Complications

analysis. M:F 58%:42%, Diagnosis: stroke 93 (72%); other brain injury 29 (22%); other neurologic condition 7 (5%). Interventions: BoNT-A (total dose: Dysport 150-1500 units or Botox 50-400 units) followed by physical therapy interventions, according to the normal clinical practice for each center. Main Outcome Measures: Achievement of primary and secondary goals, and other outcome measures, as routinely recorded by each center. Results: A total of 499 muscles (range 1-9) were injected; 117 (91%) of patients received at least 1 concomitant therapy. Primary goals were: improved passive function n 76 (59%), active function n 16 (12%), pain reduction n 19 (15%), and control of involuntary movements n 18 (14%). Achievement was recorded in 126 patients as “fully” 66 (51%), “partially” 48 (37%), and “not” achieved 12 (9%). Of 380 secondary goals, 345 (91%) were either fully (40%) or partially (51%) achieved. A wide range of other measures were recorded, including Ashworth scale (n 70), goniometry (n 47) visual analog/verbal rating scales (n 36). Carer rating and photographs did not happen quite as often as they were planned. Conclusions: Although there was wide diversity with respect to normal clinical practice and documentation, the recording of goals and their achievement was readily undertaken by most clinicians. Further training is required, however, to develop consistent methods of recording goal attainment for the larger study.