Extremely stressful experiences of the ICU are associated with subsequent psychological distress. Female sex, agitation and extreme fear during the ICU stay seem to increase the risk of developing high levels of acute PTSD-related symptoms.

The use of a multi-factorial intervention program in elderly hip fracture patients, lucid at admission, reduced the incidence of delirium during hospitalization by 35%.

No abstract

Solid octaaqua(kappa(2)O-perchlorato)thorium(IV) perchlorate hydrate, [Th(H(2)O)(8)(ClO(4))](ClO(4))(3).H(2)O, 1, and aquaoxonium hexaaquatris(kappaO-trifluoromethanesulfonato)thorium(IV) trisaquahexakis(kappaO-trifluoromethanesulfonato)thorinate(IV), H(5)O(2)[Th(H(2)O)(6)(OSO(2)CF(3))(3)][Th(H(2)O)(3)(OSO(2)CF(3))(6)], 2, were crystallized from concentrated perchloric and trifluoromethanesulfonic acid solutions, respectively. 1 adopts a severely distorted tricapped trigonal prismatic configuration with an additional oxygen from the perchlorate ion at a longer distance. 2 consists of individual hexaaquatris(kappaO-trifluoromethanesulfonato)thorium(IV) and trisaquahexakis(kappaO-trifluoromethanesulfonato)thorinate(IV) ions and an aquaoxonium ion bridging these two ions through hydrogen bonding. The hydrated thorium(IV) ion is nine-coordinated in aqueous solution as determined by extended X-ray absorption fine structure (EXAFS) and large angle X-ray scattering (LAXS). The LAXS studies also showed a second hydration sphere of about 18 water molecules, and traces of a 3rd hydration sphere. Structural studies in aqueous solution of the hydrolysis products of thorium(IV) have identified three different types of hydrolysis species: a mu(2)O-hydroxo dimer, [Th(2)(OH)(2)(H(2)O)(12)](6+), a mu(2)O-hydroxo tetramer, [Th(4)(OH)(8)(H(2)O)(16)](8+), and a mu(3)O-oxo hexamer, [Th(6)O(8)(H(2)O)(n)](8+). Detailed structures of these three hydrolysis species are given. A compilation of reported solid state structures of actinoid(IV) compounds with oxygen donor ligands show a strong correlation between the An-O bond distance and the coordination number. The earlier reported U-O bond distance in the hydrated uranium(IV) ion in aqueous solution, confirmed in this study, is related to nine-coordination. The hydrated tri- and tetravalent actinoid ions in aqueous solution all seem to be nine-coordinated. The trivalent ions show a significant difference in bond distance to prismatic and capping water molecules in assumed tricapped trigonal prismatic configuration, while the tetravalent ions seem to form more regular structures, probably because of higher polarization.

This study indicates that dyssynchronization of the melatonin secretion rhythm is common in critically ill and mechanically ventilated patients. It could be hypothesized that an impairment of the melatonin rhythm may play a role in the development of sleep disturbances and delirium in intensive care patients, and that melatonin supply could reduce the incidence of these phenomena.

No abstract

The coordination chemistry of lead(II) in the oxygen donor solvents water, dimethylsulfoxide (dmso, Me(2)SO), N,N-dimethylformamide (dmf), N,N-dimethylacetamide (dma), N,N'-dimethylpropyleneurea (dmpu), and 1,1,3,3-tetramethylurea (tmu), as well as in the sulfur donor solvent N,N-dimethylthioformamide (dmtf), has been investigated by extended X-ray absorption fine structure (EXAFS) and/or large angle X-ray scattering (LAXS) in solution, and by single crystal X-ray diffraction and/or EXAFS of solid hydrates and solvates. Lead(II) may either form hemidirected complexes with large bond distance distribution and an apparent gap for excess electron density, or holodirected ones with a symmetric coordination sphere with normal bond distance distribution, depending on the strength of antibonding lead 6s/ligand np molecular orbital interactions and ligand-ligand interactions. The crystallographic data show that the solid lead(II) perchlorate and trifluoromethanesulfonate hydrate structures are hemidirected, while the solid lead(II) solvates of dma and dmpu have regular octahedral configuration with holodirected geometry and mean Pb-O bond distances in the range 2.50-2.52 Å. EXAFS data on the hydrated lead(II) ion in aqueous solution show broad bond distance distribution and a lack of inner-core multiple scattering contributions strongly indicating a hemidirected structure. The Pb-O bond distances found both by EXAFS and LAXS, 2.54(1) Å, point to a six-coordinate hydrated lead(II) ion in hemidirected fashion with an unevenly distributed electron density. The results obtained for the dmso solvated lead(II) ion in solution are ambiguous, but for the most part support a six-coordinate hemidirected complex. The mean Pb-O bond distances determined in dmf and dma solution by LAXS, 2.55(1) and 2.48(1) Å, respectively, indicate that in both solvate complexes lead(II) binds six solvent molecules with the former complex being hemidirected whereas the latter is holodirected. The dmpu and tmu solvated lead(II) ions have a regular holodirected octahedral configuration, as expected given their space-demanding characteristics and ligand-ligand intermolecular interactions. The dmtf solvated lead(II) ion in solution is most likely five-coordinate in a hemidirected configuration, with a mean Pb-S bond distance of 2.908(4) Å. New and improved ionic radii for the lead(II) ion in 4-8-coordination in hemi and holodirected configurations are proposed using crystallographic data.

No abstract