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8-Methoxy-1-tetralone was synthesized in a concise and efficient manner involving a sequential palladium-mediated cross-coupling reaction (Heck), catalytic hydrogenation, and intramolecular acylation mediated by Eaton’s reagent or Lewis acids. The pivotal step in the synthesis was the use of a bromine substituent at the benzenoid C4 position of the intermediate methyl 4-arylbutyric ester to ensure cyclization ortho to the methoxy moiety and obviate cyclization at the para position to the thermodynamically preferred 6-methoxy-1-tetralone, the sole product obtained in the absence of this blocking group.

The E ring regioselective acid-catalyzed opening of spirostanic sapogenins possessing a carbonyl group at C-12, such as botogenin and hecogenin, provided the new 12,23-cyclo-22,26-epoxycholesta-11,22-diene skeleton, in addition to new compounds of the already known 12,23-cyclocholest-12(23)-en-22-one frameworks. This transformation proceeds in a single step, under slightly acidic conditions. Both, penta- and hexacyclic steroids were obtained with retention of configuration of all asymmetric centers.

Resumen: Objetivo: Presentar cinco pacientes con trastornos conductuales durante el sueño, sin conciencia posterior de los mismos, inducidos por zolpidem. Métodos: Evaluación con un cuestionario diseñado para estudiar las características y las conductas realizadas durante el sueño por todos los pacientes. Resultados: Las conductas realizadas por los pacientes fueron muy variadas (telefonear, limpieza y labores del hogar, alimentar al perro o depilarse), aunque en todos los pacientes se recogieron conductas alimentarias inapropiadas. Todos sufrieron una ganancia ponderal importante, debido a su preferencia por alimentos hipercalóricos durante los episodios, que en una de las pacientes desembocó en una obesidad extrema. Dos de los pacientes sufrieron lesiones (cortes con cuchillo y quemaduras) en relación con el intento de elaboración de platos. Un paciente llegó a ingerir un laxante. Conclusiones: La retirada de zolpidem resolvió de forma inmediata las conductas anormales durante el sueño en todos los casos. Esto subraya la importancia de diagnosticar adecuadamente este efecto secundario. Abstract: Objective: To present five patients with zolpidem-induced sleep-related behavioural disorders. Methods: Evaluation using a questionnaire designed to study sleep behaviours and past medical history in all patients. Results: The patients performed complex actions while sleep-walking (telephoning, house-cleaning, feeding the dog or waxing their legs). Inappropriate feeding behaviour with excessive food intake during the night were reported by all patients. All had weight gain, which in one patient led to extreme obesity. Two patients suffered injuries (knife cuts and burns) related to attempting to prepare food. One patient took a laxative. Conclusion: Withdrawal of zolpidem resolved the behaviours in all cases, highlighting the importance of an adequate diagnosis of this side effect. Palabras clave: Zolpidem, Síndrome de la cena durante el sueño, Síndrome del comer nocturno, Sonambulismo, Sueño, Efecto secundario, Obesidad, Hiperfagia, Amnesia, Keywords: Zolpidem, Sleep-related food disorder, Nocturnal eating syndrome, Sleepwalking, Sleep, Side effect, Obesity, Hyperphagia, Amnesia

Objective: To present five patients with zolpidem-induced sleep-related behavioural disorders. Methods: Evaluation using a questionnaire designed to study sleep behaviours and past medical history in all patients. Results: The patients performed complex actions while sleep-walking (telephoning, house-cleaning, feeding the dog or waxing their legs). Inappropriate feeding behaviour with excessive food intake during the night were reported by all patients. All had weight gain, which in one patient led to extreme obesity. Two patients suffered injuries (knife cuts and burns) related to attempting to prepare food. One patient took a laxative. Conclusion: Withdrawal of zolpidem resolved the behaviours in all cases, highlighting the importance of an adequate diagnosis of this side effect. Resumen: Objetivo: Presentar cinco pacientes con trastornos conductuales durante el sueño, sin conciencia posterior de los mismos, inducidos por zolpidem. Métodos: Evaluación con un cuestionario diseñado para estudiar las características y las conductas realizadas durante el sueño por todos los pacientes. Resultados: Las conductas realizadas por los pacientes fueron muy variadas (telefonear, limpieza y labores del hogar, alimentar al perro o depilarse), aunque en todos los pacientes se recogieron conductas alimentarias inapropiadas. Todos sufrieron una ganancia pon-deral importante, debido a su preferencia por alimentos hipercalóricos durante los episodios, que en una de las pacientes desembocó en una obesidad extrema. Dos de los pacientes sufrieron lesiones (cortes con cuchillo y quemaduras) en relación con el intento de elaboración de platos. Un paciente llegó a ingerir un laxante. Conclusiones: La retirada de zolpidem resolvió de forma inmediata las conductas anormales durante el sueño en todos los casos. Esto subraya la importancia de diagnosticar adecuadamente este efecto secundario. Keywords: Zolpidem, Sleep-related food disorder, Nocturnal eating syndrome, Sleepwalking, Sleep, Side effect, Obesity, Hyperphagia, Amnesia, Palabras clave: Zolpidem, Síndrome de la cena durante el sueño, Síndrome del comer nocturno, Sonambulismo, Sueño, Efecto secundario, Obesidad, Hiperfagia, Amnesia

A number of unexpected reactions were observed during attempts to invert configuration at C16 in 16alpha,17alpha,22-triol 3a. The PDC oxidation of 3a produced the D-seco-aldehyde 4a. Analogous compound 4b was obtained by Swern oxidation of the 16alpha,17alpha-dihydroxy-22-O-TES-ether 3b in addition to the desired 16-ketone 7. The unprotected triol 3a yielded pentacyclic products 5 and 6 under similar conditions. The Mitsunobu reaction of the triol 3a afforded 16-ketone 8 with inverted configuration of the side chain. During heating of a solution of 3a in THF with NaH at reflux autoxidation to the 16-ketone cyclic hemiketal 5, identical to one of the Swern oxidation products, took place.

Three new cholestane frameworks of type (II) are obtained by reductive cleavage of the F-ring of oxoepoxycholestane derivatives (I) without detectable competing 1,2-reduction of the α,β-unsaturated carbonyl group at C-22.

The synthesis and biological evaluation of three new cholestane frameworks of the type: (25R)-3β,16β-Diacetoxy-23-ethylidene-26-hydroxy-22-oxocholestane, starting from spirostanic sapogenins of the 25R series, is described. The compounds were obtained by the reductive cleavage of the F ring of 22-oxo-231,26-epoxycholestane derivatives using 9-BBN. These modified derivatives exhibit cytotoxic activity against CEM and MCF7 cells and are able to induce apoptosis in them. Its effect on the cell cycle was determined.

A number of unexpected reactions were observed during attempts to invert configuration at C16 in 16alpha,17alpha,22-triol 3a. The PDC oxidation of 3a produced the D-seco-aldehyde 4a. Analogous compound 4b was obtained by Swern oxidation of the 16alpha,17alpha-dihydroxy-22-O-TES-ether 3b in addition to the desired 16-ketone 7. The unprotected triol 3a yielded pentacyclic products 5 and 6 under similar conditions. The Mitsunobu reaction of the triol 3a afforded 16-ketone 8 with inverted configuration of the side chain. During heating of a solution of 3a in THF with NaH at reflux autoxidation to the 16-ketone cyclic hemiketal 5, identical to one of the Swern oxidation products, took place.

There is a strong association between the e4 allele of apolipoprotein E (APOE) and Alzheimer's disease (AD). This converts this allele into a risk factor for the development of AD. The association between APOE4 and dementia with Lewy bodies (DLB) is under discussion. In DLB, the presence of APOE4 has been related with a greater amount of senile plaques and neurofibrillary tangles.This is a case-control study in which the APOE genotype was determined using the modified PCR technique of Wenham in 306 patients with diagnosis of probably AD, NINCDS-ADRDA criteria, 58 cases of probably DLB, McKeith et al. consensus criteria (1996), all of them with SPECT with pathological 123I-FP-CIT and 80 normal controls (NC) having similar age and gender distribution.The frequency of alleles was: DLB group epsilon4: 16%; epsilon3: 75%; epsilon2: 9%; AD: epsilon4: 32%; epsilon3: 67%; epsilon2: 1%; and in the normal control group: epsilon4: 12%; epsilon3: 83%; epsilon2: 5%. The percentage of alleles in both genders was similar in the three groups.APOE4 percentage in DLB group (16%) was lower than in AD group (32%), and similar to the control group (12%). Considering that the presence of morphopathological Alzheimer type alterations in DBL, essentially neurofibrillary tangles, is inversely correlated with the presence of Parkinsonian signs, this group may represent pure forms of the disease, although the lack of neuropathological demonstration does not make it possible to confirm this hypothesis.

Chronic relapsing inflammatory optic neuropathy is a disease that should be distinguished from demyelinating optic neuropathy (ON). Long-term immunosuppressive therapy is usually necessary and either an inflammatory granulomatous origin or a relationship with neuromyelitis optica (NMO) is hypothesized. We report a 43-year-old man who suffered from several ON episodes affecting one eye or the other. These ON attacks completely disappeared with steroid therapy but relapsed after its withdrawal. IgG-NMO antibodies were negative.