In perforated appendicitis, the use of empirical antibiotics seems to be safe. In some cases of Pseudomonas infection, adequate antibiotics should be considered.

-046Palladium-Catalyzed Carbocyclization/Silastannylation and Distannylation of Bis(allenes).-The first Pd-catalyzed carbocyclization of bis(allenes) leading to five-membered rings via silastannylation and distannylation, respectively, is presented. A striking reversal of stereochemistry is observed changing from silastannylation to distannylation.

Lactate levels in metformin users were initially elevated in the early phase of resuscitation from severe sepsis and septic shock. However, there was no significant difference in lactate levels, LC, and normalization over the initial 24 h period based on metformin use.