[14C]Dimethyltitanocene and [14C]Methyl(methyltrimethylsilyl) titanocene–Reagents for the [14C]olefination of carbonyl compounds: synthesis of [14C]Aprepitant

A neurokinin (NK‐1) receptor antagonist, [¹⁴C]Aprepitant, was synthesized using two labeled olefination reagents: [¹⁴C]dimethyltitanocene 1 and [¹⁴C]methyl (methyltrimethylsilyl)titanocene 7. Both reagents can be readily prepared from [¹⁴C]methyllithium and have been shown to convert a variety of carbonyls to [¹⁴C]methylenes in good radiochemical yields. Copyright © 2009 John Wiley & Sons, Ltd.     

A population-based study of acute medical conditions associated with bullous pemphigoid

Background  Bullous pemphigoid is associated with poorly understood dramatically increased early mortality rates.
Objectives  To assess the incidence of acute events predisposing to early mortality.
Methods  Computerized medical records from the Health Improvement Network, a large population-based U.K. general practice database, were used to conduct a cohort analysis. Outcome measures were incidence rates of myocardial infarction, pulmonary embolism, pneumonia and sepsis compared with a matched control population.
Results  People with bullous pemphigoid were three times as likely to develop pneumonia, adjusted rate ratio 2·94 [95% confidence interval (CI) 2·01–4·31] or pulmonary embolism, adjusted rate ratio 3·12 (95% CI 1·37–7·12) compared with matched controls. No statistically significant increase was seen for myocardial infarction, adjusted rate ratio 1·24 (95% CI 0·66–2·33), or sepsis, adjusted rate ratio 2·02 (95% CI 0·78–5·21).
Conclusions  The risk of pulmonary embolism and pneumonia is increased following a diagnosis of bullous pemphigoid. It may be possible to reduce associated mortality through considering prophylaxis with either antithromboembolic measures or antibiotic therapy and vaccination.