The syntheses of different enantiomerically N-acyl N-alkyl p-toluenesulfinamides 5, by N-sulfinylation of primary amines with (S)-menthyl-p-tolylsulfinate followed by N-acylation of the resulting sulfinamides are reported. Their reactions with some C-nucleophiles take place at the sulfur atom exclusively with complete retention of the enantiomeric purity, revealing their ability as sulfinylating agents. In this sense, their comparison with other reagents popularly used, revealed that 5 have some important advantages. The commercially available enantiomerically pure (+) and (-)-menthyl sulfinates (1) are the most popular and used sources of the homochiral p-tolylsulfinyl groups. 2 Recently, two seminal contributions to the chemistry of sulfinylamides have evidenced their relevance in the preparation of enantiomerically pure sulfoxides. Evans et ai.3 have established that diastereo-and enantiomerically pure N-sulfinyloxazolidinones 2 and 3 are valuable reagents to transfer homochiral sulfinyl moieties to a variety of nucleophiles. In this sense, these compounds are probably the most powerful reagents so far described. On the other hand, Wills et al. 4 have reported several papers which demonstrate that cyclic sulfinamide 4 can also be used as a recoverable source of chiral sulfoxides and it has been used to achieve sulfinylations not possible by using the menthyl sulfinate. In addition to the sulfur atom, compounds 2-4 exhibit at least one more stereogenic centre apparently without any relevant role in their main application, the R-SO group transference. It suggests that the more simple N-sulfinylamides, 5, could act as efficient sulfinylating agents. In this sense, the scope of compounds 5 would be limited to the synthesis ofp-tolyl sulfinyl derivatives. Nevertheless, this would not be a serious inconvenient because they are the usual sulfoxides involved in asymmetric transformations. As additional interest, these compounds could be used to get asymmetric transformations at their acyl moiety, taking advantage of the ability of the sulfinyl oxygen to form chelates, 5 whose structures would be similar to those of 6 and 7, respectively derived from N-acyl oxazolidinones 6 and N-acryloyl oxazolidinones, 7 which have been extensively used in asymmetric synthesis. As a part of a general programme concerning the asymmetric synthesis based on the use of the sulfinyl group as chiral inductor, 8 we were interested in the search for new sulfinylating reagents. Thus, taking into account the above considerations, N-acylsulfinamides 5 were interesting candidates for study.

Vascular access is a potentially fatal vulnerability for hemodialysis patients, and a notable area for improvement for healthcare providers. Hemodialysis central venous catheters (HD-CVC) are associated with increased morbidity and mortality from infectious complications. Clinical practice guidelines on vascular access for hemodialysis and infection control do not provide a standard definition for infection of the HD-CVC exit site. The main aim of this protocol is to establish consensus on the signs and symptoms for preventing CVC exit site infection for patients receiving hemodialysis, based on the opinion of a panel of experts. The secondary study aim is to determine the optimum treatment approach according to the signs and symptoms of infection at the HD-CVC exit site, as prioritized by the panel of experts. For this purpose, a modified ranking-type Delphi technique will be used, with three rounds of evaluation conducted via an online questionnaire: the first two rounds will be used to prioritize, by consensus, the most relevant signs and/or symptoms of infection of the HD-CVC exit site or tunnel. Once this consensus has been achieved, a third round of evaluation will be conducted, asking the participants to ascertain the most appropriate treatment approach. The research team has drawn up a list of signs and symptoms related to infection of the HD-CVC exit site or tunnel, based on the definitions obtained from a previous systematic review. The results of the present study will enable us to design an assessment scale for HD-CVC exit sites, thus facilitating early identification and action if infection occurs. The availability of such an instrument will benefit not only clinical practice, but also research, healthcare education and training programs for professionals in this area.

[ J. L. Cobo Sánchez, et al ]Factores sociológicos y calidad de vida relacionada con la salud en pacientes en hemodiálisis 9999 Rev Soc Esp Enferm Nefrol 2011; 14 (2): 98/104

No abstract

No abstract