RESUMEN
2,5-Dihydroxy-[1,4]-benzoquinone (DHBQ) reacts readily with secondary amines to 2,5-diamino compounds and with thiols to the corresponding 2,5-dithioether derivatives. The literature has been inconclusive about the detailed mechanism, as both ipso-substitution at C-2/C-5 and the sequence of C-3/C-6 addition and C-2/C-5 elimination would give exactly the same products. By means of selectively 13C isotopically labelled DHBQ it was demonstrated that the reaction with morpholine is an ipso-substitution, while the reaction with benzenethiol and 1-hexanethiol proceeds according to the addition/elimination mechanism, and the reaction with the respective thiolates according to both mechanisms in parallel. Strongly acidic media cause a peculiar "OH-fluxuational" effect in DHBQ with the two quinone oxygens and the two hydroxy groups changing positions relative to the carbon skeleton while maintaining the 2,5-dihydroxy-[1,4]-diketo pattern. With this study, the mechanism of the unwanted nitrogen and sulfur fixation in cellulose fiber processing and during degradation could be better understood.
RESUMEN
BACKGROUND: Currently, 49% of deaths in Austria occur in a hospital which makes in-patient quality of care as well as quality of death and dying a highly relevant topic. In this article, we compare the quality of care and death and dying in departments of internal medicine and palliative care in hospitals from the perspective of relatives. METHODS: In a pilot study, 210 relatives of patients who died on 4 departments of internal medicine and 2 departments of palliative care in the state of Styria (Austria) were interviewed in 2015-2017 by means of a postal survey with regard to communication by hospital personnel, quality of care, and time of dying. RESULTS: Compared to the departments of internal medicine, the 2 departments of palliative care were perceived to provide better quality of care and better service with regard to the time of death and dying, that is, timely communication of critical health deterioration of the patient, enabling relatives' attendance at the time of death, preparing relatives, and the quality of death of the patient. CONCLUSION: Against the background of the large proportion of individuals who die in hospitals in Austria, this exploratory study showed that relatives perceived both better quality of care and better quality of death and dying in the assessed departments of palliative care compared to the departments of internal medicine. Thus, a more comprehensive and systematic evaluation of the potential added value of palliative care teams in Austrian hospitals is recommended.