Full chirality transfer in the synthesis of hindered tertiary boronic esters under in situ lithiation-borylation conditions.

Hindered tertiary neopentyl glycol boronic esters can be prepared by using in situ lithiation-borylation of enantiopure secondary benzylic carbamates at -20 °C with full chirality transfer.

Catalytic cyclopropanation of alkenes using diazo compounds generated in situ. A novel route to 2-arylcyclopropylamines.

[reaction: see text]. A user-friendly, one-pot process for catalytic cyclopropanation of alkenes from tosylhydrazones is described. The cyclopropanation of N-vinylphthalimide provides a new route to 2-arylcyclopropylamines, and this is exemplified in the efficient synthesis of the HIV-1 reverse transcriptase inhibitor 6.

Covert bacteriuria: long term follow up.

In a longitudinal prospective study 58 schoolgirls with covert bacteriuria were followed up for an average of 11.2 years (range 8.8 to 13.5 years). Intravenous urography was carried out at the start of the study (aged 4 to 11 years) and after completion of the follow up period (aged 14.8 to 22.3 years). After random allocation 27 of these girls received intermittent treatment for covert bacteriuria for the first four years and the control group received no treatment. The effect of covert bacteriuria, treatment, vesicoureteric reflux, and reflux nephropathy at presentation on the final renal length, progression of scarring, and development of new scars was analysed. No new scars were found in girls with bilaterally normal kidneys. In girls with reflux nephropathy, three kidneys showed progression of existing scars and two kidneys developed new scars. It was shown that final renal length was not influenced by vesicoureteric reflux or treatment, but reduced renal length at final assessment was associated with the presence of kidney scarring at initial assessment.

Vesicoureteric reflux: screening of first degree relatives.

Thirty three healthy infants and children with a family history of reflux nephropathy or vesicoureteric reflux in first degree relatives were screened for upper urinary tract abnormalities (renal scarring or pelvicaliceal dilatation) using ultrasound scanning or intravenous urography, or both. In addition, micturating cystourethrography was carried out in all infants and children under 2 years old (n = 20) and in children over 2 years old in whom abnormalities of the upper renal tract (renal scarring) had been found (n = 3). Upper renal tract abnormalities were found in four of the total of 33 children (12%) and vesicoureteric reflux in 12 of the 23 who underwent micturating cystourethrography (52%). Screening of infants and children was acceptable to parents. This approach has enabled the diagnosis of vesicoureteric reflux to be made in an appreciable number of children before the development of urinary tract infections and reflux nephropathy. Prospective follow up of this group will provide more information about the natural history of sterile vesicoureteric reflux.

Diffuse nephrocalcinosis and idiopathic renal hypercalciuria.

A 12 year old boy presented with primary nocturnal enuresis. Investigation showed extensive bilateral nephrocalcinosis of no obvious or recognised cause. Persistent severe renal hypercalciuria was confirmed by an intravenous calcium infusion. Idiopathic hypercalciuria is not a common cause of nephrocalcinosis and has not previously been described in a child.