Chlorido{N-[2-(diphenyl-phosphan-yl)benzyl-idene]-2,6-diisopropyl-aniline-κP}gold(I) chloro-form 0.25-solvate.

The asymmetric unit of the title compound, [AuCl(C31H32NP)]·0.25CHCl3, contains two independent complex mol-ecules and half a chloro-form solvent mol-ecule, which is disordered across an inversion center. The Au(I) ions are each coordinated in a slightly distorted linear environment, with P-Au-Cl angles of 177.20 (4) and 178.54 (4)°.

Chlorido{[(E)-2-(diphenyl-phosphan-yl)benzyl-idene](furan-2-ylmeth-yl)amine-κP}gold(I).

In the title complex, [AuCl(C24H20NOP)], the ligand has N, P and O electron-donating atoms but the Au(I) atom is coordinated only by the 'soft' P atom and an additional Cl atom in an almost linear fashion. Important geometrical parameters include Au-P = 2.2321 (13) Å, Au-Cl = 2.2820 (13) Šand P-Au-Cl = 176.49 (5)°. The furan ring is disordered over two positions in a 0.51 (2):0.49 (2) ratio.

A review of verbal order policies in acute care hospitals.

BACKGROUND: Although verbal and telephone orders (VOs) are commonly used in the patient care process, there has been little examination of the strategies and tactics used to ensure their appropriate use or how to ensure that they are accurately communicated, correctly understood, initially documented, and subsequently transcribed into the medical record and ultimately carried out as intended. A systematic review was conducted of hospital verbal and telephone order policies in acute care settings. METHODS: A stratified random sample of hospital verbal and telephone order policy documents were abstracted from critical access, rural, rural referral, and urban hospitals located in Iowa and Missouri and from academic medical centers from across the United States. FINDINGS: Substantial differences were found across 40 acute care settings in terms of who is authorized to give (including nonlicensed personnel) and take VOs and in terms of time allowed for the prescriber to cosign the VO. When a nonphysician or other licensed prescriber was allowed to communicate VOs, there was no discussion of the process to review the VO before it was communicated in turn to the hospital personnel receiving the order. Policies within several of the same hospitals were inconsistent in terms of the periods specified for prescriber cosignature. Few hospitals required authentication of the identity of the person making telephone VOs, nor the use of practices to improve communication reliability. CONCLUSION: Careful review and updating of hospital VO policies is necessary to ensure that they are internally consistent and optimize patient safety. The implementation of computerized medical records and ordering systems can reduce but not eliminate the need for VOs.

(η(6)-Benzene)-dichlorido(dicyclo-hexyl-phenyl-phosphane)ruthenium(II) benzene sesquisolvate.

The asymmetric unit of the title compound, [RuCl2(C6H6)(C18H27P)]·1.5C6H6, contains one mol-ecule of the Ru(II) complex and one and a half solvent molecules as one of these is located about a centre of inversion. The Ru(II) atom has a classical three-legged piano-stool environment being coordinated by an η(6)-benzene ligand [Ru-centroid = 1.6964 (6) Å], two chloride ligands with an average Ru-Cl bond length of 2.4138 (3) Šand a dicyclo-hexyl-phenyl-phosphane ligand [Ru-P = 2.3786 (3) Å]. The effective cone angle for the phosphane was calculated to be 158°. In the crystal, weak C-H⋯Cl hydrogen bonds link the Ru(II) complexes into centrosymmetric dimers. The crystal packing exhibits intra- and inter-molecular C-H⋯π inter-actions resulting in a zigzag pattern in the [101] direction.

trans-Dichloridobis{tris-[4-(trifluoro-methyl)phen-yl]phosphane-κP}palla-dium(II) dichloro-methane monosolvate.

The title compound, [PdCl2(C21H12F9P)2]·CH2Cl2, crystallizes with two independent complex molecules (each having the Pd(II) atom situated on an inversion centre) and a dichloro-methane molecule in the asymmetric unit. The independent Pd(II) atoms are in perfectly linear orientations of the ligands in mutually trans positions, but distortions of the Cl-Pd-P angles ranging from 86.151 (19) to 93.849 (19)° are evident. The effective cone angles for the tris-[4-(trifluoro-meth-yl)phen-yl]phosphane ligand were calculated to be 159 and 161°. In the crystal, weak C-H⋯Cl/F inter-actions create a three-dimensional supramolecular network. Loose packing at two of the -CF3 groups resulted in large thermal vibrations which were treated as two-component disorders [occupancy ratios 0.50:0.50 and 0.628 (15):0.372 (15)].

trans-Dichloridobis{dicyclo-hex-yl[4-(dimethyl-amino)-phen-yl]phosphane-κP}platinum(II) dichloro-methane disolvate.

In the title complex, trans-[PtCl2{P(C6H11)2(4-Me2NC6H4)}2]·2CH2Cl2, the Pt(II) atom is located on an inversion centre, resulting in a trans-square-planar geometry. Important geometric parameters are the Pt-P and Pt-Cl bond lengths of 2.3258 (6) and 2.3106 (6) Å, respectively, and the P-Pt-Cl angles of 89.64 (2) and 90.36 (2)°. The effective cone angle for the dicyclo-hex-yl[4-(dimethyl-amino)-phen-yl]phosphane unit was calculated to be 164°. The compound crystallizes with two dichloro-methane solvent mol-ecules; one of which is severely disordered and was treated using the SQUEEZE routine in PLATON [Spek (2009 ▶). Acta Cryst. D65, 148-155].

trans-Di-µ-chlorido-bis-{chlorido[tris-(3,5-dimethyl-phen-yl)phosphane-κP]palla-dium(II)} dichloro-methane monosolvate.

In the dimeric title compound, [Pd2Cl4{P(C8H9)3}2]·CH2Cl2, the metal complex molecule is situated about an inversion centre and is accompanied by a dichloro-methane solvent mol-ecule situated on a twofold rotation axis. The Pd(II) atom has a slightly distorted square-planar coordination sphere. The effective cone angle for the tris-(3,5-dimethyl-phen-yl)phos-phane ligand was calculated to be 169°. In the crystal, the metal complex and solvent mol-ecules are linked via C-H⋯Cl inter-actions, generating chains along [10-2]. There are also C-H⋯π and weak π-π inter-actions present [centroid-centroid distance = 3.990 (2) Å, plane-plane distance = 3.6352 (15) Šand ring slippage = 1.644 Å], forming of a three-dimensional structure.

Di-µ-chlorido-bis-({8-[bis-(naphthalen-1-yl)phosphan-yl]naphthalen-1-yl-κ(2) C (1),P}palladium(II)) dichloro-methane disolvate.

The title compound, [Pd2{P(C10H7)2(C10H6)}2Cl2]·2CH2Cl2, shows cyclo-metalation of one naphthalen-1-yl substituent of each of the phosphane ligands to the Pd dimer in a trans orientation; the complete dimer is generated by a centre of inversion. Two dichloro-methane solvent mol-ecules create C-H⋯Cl inter-actions with the metal complex, generating supermolecular layers in the ab plane. Additional C-H⋯π and π-π [centroid-centroid distances = 3.713 (3), 3.850 (4) and 3.926 (3) Å] inter-actions join these planes into a three-dimensional supermolecular network.

Tris(naphthalen-1-yl)phosphane chloro-form hemisolvate.

The title compound, P(C10H7)3·0.5CHCl3, was isolated after the unsuccessful reaction of KSeCN and tris-(naphthalen-1-yl)phosphane. The solvent mol-ecule is disordered about an inversion center. The effective cone angle of the phosphine is 203°. In the crystal, weak C-H⋯Cl and C-H⋯π inter-actions are observed.

Diphenyl(pyridin-2-yl)-phosphane selenide.

In the title compound, C(17)H(14)NPSe, the P atom has a distorted tetra-hedral environment resulting in an effective cone angle of 163°. In the crystal, C-H⋯Se/N/π inter-actions are observed.

[4-(Dimethyl-amino)-phen-yl]diphenyl-phosphine selenide.

In the title compound, C(20)H(20)NPSe, the P atom lies in a distorted tetra-hedral environment. The Tolman cone angle is 157° indicating steric crowding at this atom. In the crystal, weak C-H⋯Se inter-actions create linked dimeric units and C-H⋯π inter-actions are also observed.

(η(6)-Benzene)-(benzyl-diphenyl-phos-phane)dichloridoruthenium(II).

In the title compound, [RuCl(2)(C(6)H(6))(C(19)H(17)P)], the Ru(II) atom has a distorted pseudo-octa-hedral coordination environment with the metrical parameters around the metallic core as Ru-centroid(η(6)-benzene) = 1.6894 (11) Å, Ru-P = 2.3466 (6), Ru-Cl(avg.) = 2.4127 (7) Å; Cl-Ru-Cl = 88.07 (2) and Cl-Ru-P = 82.77 (2), 87.65 (2)°. The effective cone angle for the benzyl-diphenyl-phosphane was calculated to be 143°. In the crystal C-H⋯Cl and C-H⋯π inter-actions are observed.

(Acetyl-acetonato-κ(2)O,O')[(2-bromo-phen-yl)diphenyl-phosphane-κP]carbonyl-rhodium(I).

In the title compound, [Rh(C(5)H(7)O(2))(C(18)H(14)BrP)(CO)], the Rh(I) atom adopts a slightly distorted square-planar geometry involving two O atoms [Rh-O = 2.077 (2) and 2.033 (2) Å] of the acetyl-acetonate ligand, one carbonyl C atom [Rh-C = 1.813 (2) Å] and one P atom [Rh-P = 2.242 (5) Å] of the PPh(2)(2-BrC(6)H(4)) phosphane ligand. Difference electron density maps indicate a disorder of the Br atom over two positions in an approximate 0.95:0.05 ratio. However, this disorder could not be resolved satisfactorily with the present data.

(Acetyl-acetonato-κ(2)O,O')carbon-yl[dicyclo-hex-yl(2,6-diisopropyl-phen-yl)phosphane-κP]rhodium(I).

In the title compound, [Rh(C(5)H(7)O(2)){C(12)H(17)P(C(6)H(11))(2)}(CO)], the Rh(I) atom is coordinated by one carbonyl C, one P and two O atoms, forming a slighlty distorted square-planar configuration.

In search of the best peritoneal adhesion model: comparison of different techniques in a rat model.

BACKGROUND: Adhesion-related complications after abdominal surgery result in significant morbidity and costs. Results from animal studies investigating prevention or treatment of adhesions are limited due to lack of consistency in existing animal models. The aim of this study was to compare quality and quantity of adhesions in four different models and to find the best model. MATERIALS AND METHODS: This study was approved by the University of Missouri Animal Care and Use Committee (ACUC). Forty female rats were randomly assigned to four different groups of 10 animals each. Adhesion created was performed utilizing the four techniques: Group 1 - parietal peritoneum excision (PPE), Group 2 - parietal peritoneum abrasion (PPA), Group 3 - peritoneal button creation (PBC), and Group 4 - cecal abrasion (CA). Rats were allowed to recover and necropsy was performed on postoperative d 14. Adhesions were scored by an established quantitative and qualitative scoring systems. The midline incision served as the control in each animal. RESULTS: The four groups were not equal with respect to both quantity score (P<0.001) and quality score (P=0.042). The PBC group had the highest quantity of adhesions. The highest quality of adhesion was seen in the PPE group. A multivariate analysis carried out to quantify the performance of each model clearly demonstrated that PBC exhibited the best results in terms of both quantity and quality. CONCLUSIONS: The button technique (PBC) is most consistent and reproducible technique for an intra-abdominal adhesion model. This model can help in the study and development of substances to prevent adhesion formation in the future.

cis-Bis(benzyl-diphenyl-phosphane-κP)dichloridoplatinum(II) dichloro-methane sesquisolvate.

The asymmetric unit of the title compound, [PtCl(2)(C(19)H(17)P)(2)](2)·3CH(2)Cl(2), contains two complex mol-ecules and three dichloro-methane solvent mol-ecules, two of which are disordered over various positions. The Pt(II) complexes reveal a slightly distorted square-planar geometry with average Pt-P and Pt-Cl bond lengthss of 2.252 (8) and 2.363 (8) Å, respectively, and average P-Pt-P and Cl-Pt-Cl angles of 99.17 (8) and 87.1 (7)°, respectively.

(Acetyl-acetonato-κO,O')carbon-yl{dicyclo-hex-yl[4-(dimethyl-amino)-phen-yl]phosphane-κP}rhodium(I).

The title compound, [Rh(C(5)H(7)O(2))(C(20)H(32)NP)(CO)], features an acetyl-acetonate-chelated Rh(I) cation coordinated by one P [Rh-P = 2.2525 (7) Å], one carbonyl C [Rh-C = 1.792 (3) Å] and two O [Rh-O = 2.0582 (17) and 2.0912 (18) Å] atoms in a slightly distorted square-planar geometry. Mol-ecules are packed in positions of least steric hindrance, with the phosphane ligands positioned above and below the Rh-acetyl-acetonate backbone.

Di-chlorido-(η6-p-cymene)[tris-(4-meth-oxy-phen-yl)phosphane]ruthenium(II).

The title compound, [RuCl2(C10H14)(C21H21O3P)], crystallizes with two complex mol-ecules in the asymmetric unit. The RuII atom has a classical three-legged piano-stool environment being coordinated by a cymene ligand [Ru-centroid = 1.707 (2)/1.704 (2) Å], a tris-(4-meth-oxy-phen-yl)phosphane ligand [Ru-P = 2.3629 (15)/2.3665 (15) Å] and two chloride atoms with the Ru-Cl bonds adopting two distinct values of 2.4068 (16)/2.4167 (16) and 2.4016 (15)/2.4244 (16) Å. The effective cone and solid angles for the phosphane ligands were calculated to be 149.5/150.2° and 25.3/25.6°, respectively. In the crystal, weak C-H⋯Cl/O/π inter-actions are observed. The crystal was refined as a two-component twin.

Steric and electronic evaluations of P(o-tol)R2, where R is phenyl or cyclohexyl: crystal structures of SeP(o-tol)R2.

The crystal structures of SeP(o-tol)R2, where o-tol is ortho-tolyl (2-methylphenyl) and R is Ph (phenyl), namely (2-methylphenyl)diphenylphosphane selenide, C19H17PSe, or Cy (cyclohexyl), namely dicyclohexyl(2-methylphenyl)phosphane selenide, C19H29PSe, were determined to aid in the evaluation of the steric and electronic behaviour of these analogous phosphane compounds. The compounds crystallized in similar monoclinic crystal systems, but are differentiated in their unit cells by a doubling of the number of independent molecules for R = Cy (Z' = 2) and the choice of glide plane by convention. The preferred orientation for the o-tolyl substituent obtained from the X-ray structural analysis is gauche for R = Ph and anti for R = Cy (using the Se-P-Cipso-Cortho torsion angles as reference). Density functional theory (DFT) calculations showed both conformations to be equally probable and indicate that the preferred solid-state conformer is probably due to the minimization of repulsion energies, resulting in a packing arrangement primarily featuring weak C-H...Se interactions and additional C-H...π interactions in the R = Ph structure. A detailed electronic and steric analysis was conducted on both phosphanes using Se-P bond lengths, multinuclear NMR 1JSe-P coupling constants, theoretical topological evaluation and crystallographic and solid-angle calculations, and compared to selected literature examples. The results indicate that the use of the o-tolyl substituent increases both the electron-donating capability and the steric size, but is also dependent on whether the o-tolyl group adopts a gauche or anti conformation. The single-crystal geometrical data are unable to detect electronic differences between these two structures due to the somewhat large displacement parameters observed for the Se atom in the R = Cy structure.

Prognostic indicators of quality of life after cholecystectomy for biliary dyskinesia.

Approximately 30 per cent of patients who undergo cholecystectomy for biliary dyskinesia will continue to have symptoms after surgery. Quality of life has not been evaluated but may be decreased in these patients. The purpose of this study was to measure quality of life after laparoscopic cholecystectomy in these patients to better define optimal treatment of biliary dyskinesia. All patients with biliary dyskinesia (defined as the absence of gallstones, and a gallbladder ejection fraction of <35%) who underwent cholecystectomy at our institution from January 31, 2000 to January 31, 2005 were identified. Preoperative data including ultrasound, biochemical data, and pathology were retrieved by chart review. Postoperative assessment included the Gastrointestinal Quality of Life Index and a symptom survey. The postoperative quality of life was compared with historic standards. The quality of life was also compared with preoperative variables to determine if any variables predicted outcome. A total of 66 patients were identified as fitting the inclusion criteria. Forty-three patients were reached by phone and 30 agreed to participate. Patients were noted to have good recall as to preoperative symptoms when the retrospective survey of symptoms was compared with the medical record. The mean +/- SD postoperative quality of life in the study population was 113 +/- 20. This is higher than in historic patients with gallbladder disease before (84 +/- 19) and after (102 +/- 13) cholecystectomy. Quality of life in the study group was lower than the healthy control (125 +/- 13). Patients having both postprandial nausea and vomiting before surgery had a lower quality of life (P < 0.029) after surgery as compared with those without these preoperative symptoms. When adjusted for nausea and vomiting, the quality of life in study patients (119 +/- 14) was similar to normal controls. No other symptom, laboratory, pathologic, or sonographic data were predictive of a lower quality of life. Cholecystectomy is beneficial for most patients with biliary dyskinesia. Nausea and vomiting were negative predictors of quality of life after cholecystectomy. These patients with nausea and vomiting may have a global gastrointestinal motility disorder and are less likely to benefit from cholecystectomy.