ABSTRACT
The preparation of O-octadecyl-S-chlorodifluoromethyl xanthate from chlorodifluoroacetic acid and its use as a convenient source of chlordifluoromethyl radicals is described. This reagent may be used to access gem-difluoroalkenes and -dienes, as well as (2,2-difluoroethyl)indolines, -indoles, and -naphthols.
ABSTRACT
The synthesis of the novel O-ethyl-S-(4-chlorophenylthio)difluoromethyl xanthate and its radical addition to various terminal alkenes are described. The geminal difluorosulfide adducts undergo closure onto the aromatic ring by further treatment with peroxide to furnish difluorothiochromans, a new family of organofluorine compounds.
Subject(s)
Chromans/chemical synthesis , Hydrocarbons, Fluorinated/chemical synthesis , Sulfur Compounds/chemical synthesis , Alkenes/chemical synthesis , Chromans/chemistry , Cyclization , Hydrocarbons, Fluorinated/chemistry , Molecular Structure , Sulfur Compounds/chemistryABSTRACT
We investigated the prevalence of intrapulmonary shunts in 82 patients with hepatic cirrhosis referred for echocardiography as part of liver transplantation evaluation. Intrapulmonary shunts were present in 49 of 82 patients (60%). Baseline characteristics were similar in patients with and without intrapulmonary shunts. Mean follow up was 41 +/- 15 months in patients with intrapulmonary shunts and 42 +/- 15 months in patients without intrapulmonary shunts (P not significant). At follow up, 8 of 49 patients (16%) with intrapulmonary shunts and 4 of 33 patients (12%) without intrapulmonary shunts had died (P not significant).
Subject(s)
Arteriovenous Anastomosis/diagnostic imaging , Liver Cirrhosis/complications , Lung/diagnostic imaging , Cross-Sectional Studies , Echocardiography , Female , Follow-Up Studies , Humans , Liver Cirrhosis/diagnostic imaging , Liver Cirrhosis/mortality , Male , Middle Aged , Prevalence , PrognosisABSTRACT
We investigated in-hospital and long-term mortality in 16 patients with infective endocarditis and paravalvular abscess on a prosthetic valve (6 of whom underwent surgery) and in 12 patients with infective endocarditis and paravalvular abscess on a native valve (8 of whom underwent surgery). The only significant risk factor for in-hospital mortality in patients with prosthetic or native value paravalvular abscess was age (P < 0.001). In-hospital mortality was 33% in patients with prosthetic valve paravalvular abscess undergoing surgery and 33% in patients treated medically (P = not significant). In-hospital mortality was 25% in patients with native valve paravalvular abscess undergoing surgery and 25% in patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with prosthetic valve paravalvular abscess was 67% for patients treated surgically versus 40% for patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with native valve paravalvular abscess was 75% for patients treated surgically versus 50% for patients treated medically (P = not significant).
Subject(s)
Abscess/etiology , Endocarditis/etiology , Heart Valve Diseases/mortality , Heart Valve Diseases/surgery , Heart Valve Prosthesis/adverse effects , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/mortality , Abscess/microbiology , Abscess/mortality , Aged , Aged, 80 and over , Aortic Valve/surgery , Echocardiography, Transesophageal , Endocarditis/microbiology , Endocarditis/mortality , Female , Follow-Up Studies , Heart Valve Prosthesis Implantation/adverse effects , Heart Valve Prosthesis Implantation/mortality , Hospital Mortality , Humans , Male , Middle Aged , Mitral Valve/surgery , New York/epidemiology , Prosthesis-Related Infections/microbiology , Survival Analysis , Treatment Outcome , Tricuspid Valve/surgeryABSTRACT
In 82 patients with infective endocarditis, including 11 with a perivalvular abscess detected by transesophageal echocardiography, age was a significant predictor of in-hospital mortality (p <0.001). At 3.8-year follow-up, 5 of 7 patients with an abscess who had valve replacement and 2 of 4 patients with an abscess who did not have surgery survived (p = NS); 13 of 22 patients (59%) with no abscess who had valve replacement and 20 of 49 patients (41%) with no abscess who did not have surgery survived (p = NS).
