A practical source of chlorodifluoromethyl radicals. Convergent routes to gem-difluoroalkenes and -dienes and (2,2-difluoroethyl)-indoles, -azaindoles, and -naphthols.

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.

A convergent route to geminal difluorosulfides and to functionalized difluorothiochromans, a new family of organofluorine compounds.

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.

Prevalence and prognosis of intrapulmonary shunts in patients with hepatic cirrhosis.

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.

Comparison of outcomes in patients with active infective endocarditis and a paravalvular abscess on a prosthetic valve versus a native valve.

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).

Comparison of outcomes in patients with active infective endocarditis with versus without paravalvular abscess and with and without valve replacement.

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.