Here it goes again: A tandem catalytic process effects sequential Pd0‐catalyzed allylic alkylations through leaving group ionization and PdII‐catalyzed allylic alkylations by CH activation. By employing an oxidative trigger to convert the catalytic species from Pd0 into PdII, both transformations can be conducted in a single reaction vessel using the same precatalyst. This allows for the selective introduction of otherwise indistinguishable allyl groups.
Sixty-three unselected consecutive patients with primary Sjögren's syndrome (pSs) were prospectively evaluated for evidence of neurological manifestations. Seventeen had a mild sensory or mixed neuropathy. Two of these plus one more patient had trigeminal neuropathy. One had pure motor neuropathy, whereas another eight had latent motor neuropathy. None volunteered neurological complaints. Two more patients had symptomatic unilateral carpal tunnel syndrome. Severe mononeuritis multiplex and symptomatic symmetrical distal neuropathy were seen in two patients with vasculitis. One patient, with a history of hypertension and no subjective sicca complaints, had a mild cerebrovascular accident and objective evidence of changes compatible with pSs. The study suggests that peripheral neurological involvement is relatively common and benign in the majority of pSs individuals, whereas central nervous system (CNS) disease must be rare.
The lack of negative effects on quality of life, the better compliance, and the comparable efficiency of SSRIs suggest that these drugs may be considered as alternative to gabapentin in painful diabetic neuropathy.
In our series, there was no difference in the incidence rate and subtypes of GBS but there was a significant seasonality with spring clustering. A transient elevation of transaminases of undetermined etiology was noted in more than a half of our patients. Although seven patients (15.21%) had significant neurologic sequelae, no deaths occurred.
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