SummaryThe effective and efficient removal of the BF2 moiety from F-BODIPY derivatives has been achieved using two common Brønsted acids; treatment with trifluoroacetic acid (TFA) or methanolic hydrogen chloride (HCl) followed by work-up with Ambersep® 900 resin (hydroxide form) effects this conversion in near-quantitative yields. Compared to existing methods, these conditions are relatively mild and operationally simple, requiring only reaction at room temperature for six hours (TFA) or overnight (HCl).
The reaction between diphenylsulfonium isopropylide and the diene esters, ethyl 1,3-cyclohexadienecarboxylate and methyl írons-2,4-hexadienoate, has been examined in dimethoxyethane, tetrahydrofuran, and tetrahydropyran. Both gave mixtures of isomeric cyclopropane products resulting from ylide addition across the ,ß and 7, double bonds. The isomer distribution in the case of the cyclic diene ester was found to be solvent dependent, whereas the acyclic system showed preferential addition to the y,S double bond irrespective of solvent. The widely used method of preparing n-alkyldiphenylsulfonium salts by reaction between diphenyl sulfide, «-alkyl halide, and silver tetrafluoroborate was found to give mixtures of primary and secondary sulfonium salts. However, pure primary alkyldiphenylsulfonium salts can be prepared, although in low yield, by the reaction of diphenyl sulfide with n-alkyl trifluoromethanesulfonates.
Clinicians assessing cardiac risk as part of a comprehensive consultation before surgery can use an expanding set of tools, including predictive risk calculators, cardiac stress tests and measuring serum natriuretic peptides. The optimal assessment strategy is unclear, with conflicting international guidelines. We investigated the prognostic accuracy of the Revised Cardiac Risk Index for risk stratification and cardiac outcomes in patients undergoing elective non-cardiac surgery in a contemporary Australian cohort. We audited the records for 1465 consecutive patients 45 years and older presenting to the perioperative clinic for elective non-cardiac surgery in our tertiary hospital. We calculated individual Revised Cardiac Risk Index scores and documented any use of preoperative cardiac tests. The primary outcome was any major adverse cardiac events within 30 days of surgery, including myocardial infarction, pulmonary oedema, complete heart block or cardiac death. Myocardial perfusion imaging was the most common preoperative stress test (4.2%, 61/1465). There was no routine investigation of natriuretic peptide levels for cardiac risk assessment before surgery. Major adverse cardiac events occurred in 1.3% (18/1366) of patients who had surgery. The Revised Cardiac Risk Index score had modest prognostic accuracy for major cardiac complications, area under receiver operator curve 0.73, 95% confidence interval 0.60 to 0.86. Stratifying major adverse cardiac events by the Revised Cardiac Risk Index scores 0, 1, 2 and 3 or greater corresponded to event rates of 0.6% (4/683), 0.8% (4/488), 4.1% (6/145) and 8.0% (4/50), respectively. The Revised Cardiac Risk Index had only modest predictive value in our single-centre experience. Patients with a revised cardiac risk index score of 2 or more had an elevated risk of early cardiac complications after elective non-cardiac surgery.
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