[RhIII(Cp*)]-catalyzed arylfluorination of α-diazoketoesters for facile synthesis of α-aryl-α-fluoroketoesters

Here we describe the Cp*Rh(iii)-catalyzed cascade arylfluorination reactions of α-diazoketoesters with arylboronic acids and N-fluorobenzenesulfonimide for one-pot C(sp3)-C(aryl) and C(sp3)-F bond formation. The arylfluorination reaction can be accomplished with remarkable chemo- and regioselectivity. Our mechanistic investigation showed that the Rh-catalyzed arylfluorination of diazoacetates occurred by (1) transmetalation of arylboronic acids to form an arylrhodium(iii) complex, (2) coupling of diazomalonates with the arylrhodium(iii) complex to form carbene-rhodium, (3) migratory carbene insertion to form a diketonato-rhodium(iii) complex - probably via rearrangement of the putative σ-alkylrhodium(iii) complex, and (4) electrophilic fluorination of the diketonato-rhodium to form the α-aryl-α-fluoromalonates.

Evaluation of the accuracy of leukocyte esterase testing to detect pyuria in young febrile children: prospective study

OBJECTIVE

To study the accuracy and clinical application of the dipstick leukocyte esterase test in the detection of pyuria in young febrile children suspected to have urinary tract infection.

DESIGN

Prospective study.

SETTING

Regional hospital, Hong Kong.

PATIENTS

Urine samples were taken from 215 children younger than 2 years who were suspected to have urinary tract infection (fever without an obvious focus of infection).

MAIN OUTCOME MEASURES

The accuracy of the dipstick leukocyte esterase test in detecting significant pyuria defined as a leukocyte count >or=10 mm(3) (>or=0.01 x 10(9) /L).

RESULTS

Two hundred and fifty-four urine samples collected by bag, midstream clean-catch, suprapubic bladder aspiration, or urethral catheterization were examined. Using urine microscopy results as a reference, the sensitivity and specificity of the leukocyte esterase test in detecting significant pyuria were found to be 72.0% and 85.8%, respectively; the positive and negative predictive values were 55.4% and 92.6%, respectively; and the positive and negative likelihood ratios were 5.1 and 0.3, respectively.

CONCLUSIONS

The dipstick leukocyte esterase test cannot accurately detect pyuria in young febrile children. It is also not appropriate as a screening test to exclude pyuria, reduce the need for the microscopic examination of urine, or indicate when a hospital admission for probable urinary tract infection is needed.