N-heterocyclic carbene stabilized phosphaalkenyl(chloro)stannylene.

The new phosphaalkenyl(chloro)tin(II) compound NHC-Sn(Cl)[C(SiMe3)=PMes*] was isolated and fully characterized including molecular structure determination by a single crystal X-ray diffraction analysis. Its reaction with Me2SAuCl led to the formation of an unprecedented P=C-bridged trinuclear gold complex [AuC(SiMe3)=PMes*]3 through the transfer of the phosphaalkenyl substituent to the gold atom.

End-of-life care for persons with advanced Alzheimer disease: design and baseline data from the ALFINE study.

CONTEXT: Alzheimer disease (AD) is the most common cause of dementia. Most affected individuals survive to an advanced stage of dementia, which is under-recognized as a terminal illness. OBJECTIVES: Our objectives were to better understand the clinical trajectory of advanced AD and to identify the palliative care needs of these patients. METHODS: This was an observational prospective study of AD patients in severe stage of disease included after a hospitalization in geriatric wards. They were followed up every three months during 2 years. At each visit, interviews provided data regarding: pain (Elderly Pain Caring Assessment scale), pressure ulcers, eating patterns, daily medications and use of health services. This paper describes the design of the ALFINE study and the characteristics of the recruited cohort. RESULTS: 112 patients were recruited (mean age: 84.03 + 6.96) years; 76.79% were women. Mean time since diagnosis of AD was 5.28 years. Pressure ulcers were observed in 42 patients. Pain assessment with the EPCA showed a mean score of 8.58. One third of patients with an EPCA score of more than 7 (median) had no analgesics. More than half of patients had been treated with antibiotics during the three months before inclusion in the study and 33 patients were still receiving antibiotics at inclusion. Two third of patients had been hospitalized in the month before inclusion. CONCLUSION: End-of-life care for individuals with end-stage AD is increasingly important because of the rising number of patients with this disease. Health care systems and clinicians should make efforts to ameliorate the suffering of patients and their caregivers.

Copper(I) complexes derived from mono- and diphosphino-boranes: Cu-->B interactions supported by arene coordination.

The monophosphino-boranes o-iPr(2)P(C(6)H(4))BR(2) (1: R = Ph and 3: R = Cy) and diphosphino-boranes [o-R(2)P(C(6)H(4))](2)BPh (5: R = Ph and 6: R = iPr) readily react with CuCl to afford the corresponding complexes {[o-iPr(2)P(C(6)H(4))BPh(2)]Cu(mu-Cl)}(2) 2, {[o-iPr(2)P(C(6)H(4))BCy(2)]Cu(mu-Cl)}(2) 4, {[o-Ph(2)P(C(6)H(4))](2)BPh}CuCl 7, and {[o-iPr(2)P(C(6)H(4))](2)BPh}CuCl 8. The presence of Cu-->B interactions supported by arene coordination within complexes 2, 7, and 8 has been unambiguously evidenced by NMR spectroscopy and X-ray diffraction studies. The unique eta(2)-BC coordination mode adopted by complexes 7 and 8 has been thoroughly analyzed by density-functional theory (DFT) calculations.

[Factors associated with the moderately severe stage of Alzheimer's disease: first results of the REAL.FR study]. / Facteurs associés au stade modérément sévére de la maladie d'Alzheimer: premiers résultats de l'étude REAL.FR.

OBJECTIVE: Most studies of Alzheimer's disease deal with the mild to moderate stages of the disease. However the great majority of cases evolve toward a stage of marked severity which can last many years. The few studies of severe dementia that have been carried out have included institutionalized patients. The aim of this study is to describe associated factors with a moderately severe Alzheimer's disease in a French community dwelling patients. METHODS: Initial data from a French cohort Study of Alzheimer's patients (REAL.FR: Réseau sur la maladie d'Alzheimer français) were analysed. These included sociodemographic and medical factors and measures of cognitive and non cognitive performance. We compared two groups according the stage of the disease: moderately severe patients (Mini Mental Status score < 15) and mild to moderate patients (Mini Mental Status score > or = 15). RESULTS: Moderately severe stage of disease was independently related to age (OR: 0.35; 95% CI: 0.16-0.78 for patient aged between 75-80 years compared to patient < or = 75 years), low educational level (non-obtention of french certificate of primary education, OR: 2.43; IC à 95%: 1.28-4.59) and disability to perform activities of daily living (OR: 3.35; 95% CI: 1.62-6.93). After multivariate analysis, there was no difference between the 2 groups for the other factors like behavioral symptoms. CONCLUSIONS: Severe dementia represents major medical and socio-economical problem. Better knowledge of the natural history of the severe stage of the disease is necessary for better clinical practice.