María Sol Rodríguez-Calvo

The anomeric alkoxyl radical β-fragmentation (ARF) of carbohydrates possessing an EWG at C2, promoted by PhI(OAc)₂/I₂, gives rise to an acyclic iodide through which a pentavalent atom of phosphorus can be introduced via the Arbuzov reaction. After selective hydrolysis and subsequent cyclization, the phosphonate or phosphinate intermediates can be converted into 2-deoxy-1-phosphahexopyranose and 2-deoxy-1-phosphapentopyranose sugars. The ARF of carbohydrates with an EDG at C2 proceeds by a radical-polar crossover mechanism and the cyclization occurs by nucleophilic attack of a conveniently positioned phosphonate or phosphinate group to the transient oxocarbenium ion. This alternative methodology leads to 5-phosphasugars with a 4-deoxy-5-phosphapentopyranose framework. The structure and conformation of the 2-oxo-1,2-oxaphosphinane and 2-oxo-1,2-oxaphospholane ring systems in different carbohydrate models have been studied by NMR and X-ray crystallography.

Attitudes toward physician-assisted death among medical students differ between populations. The aim of this study was to explore attitudes towards euthanasia and physician-assisted suicide among Spanish university students. A cross-sectional survey was conducted by asking undergraduate students (Medicine, Nursing and Law) of the University of Santiago de Compostela to complete an anonymous 17-item questionnaire. Most participants exhibited a positive attitude towards physician-assisted suicide (54%) and euthanasia (75%), as well as towards their legalization. Attitudes were consistent with the underlying ethical reasoning, with no differences in terms of age, gender or academic degree. In addition, consistency was found between attitudes and willingness to participate in physician-assisted suicide and euthanasia, should they be legal. The results showed that the attitudes of medical students towards euthanasia and physician-assisted suicide were positive and similar to non-medical students.

Resumo Em 1999, o relatório “Errar é humano: construir um sistema de saúde mais seguro” do Instituto de Medicina dos Estados Unidos concluiu que a atividade de atendimento especializado não era uma prática infalível e que havia maior probabilidade de causar eventos adversos. Para reduzir os danos dos sistemas de cuidados de saúde, os países desenvolvidos concentraram seu interesse nos cidadãos a partir dos primeiros anos do século XXI. Todas as estratégias de modernização terão como objetivo melhorar a qualidade do atendimento. Nesse contexto, a segurança do paciente é um componente-chave da qualidade assistencial. Em 2003, o Hastings Center publicou o relatório “Promover a segurança do paciente: uma base ética para a deliberação de políticas”, que faz uma reflexão ética das obrigações morais subjacentes à cultura de segurança desenvolvida na sequência da publicação do relatório “Errar é humano”.

The aims of this study were to know the opinion and general knowledge of patients about the informed consent (IC), and their participation in the decision-making (DM) process. Material and methods: A descriptive, transversal, observational, qualitative and quantitative study was designed with 120 patients randomly surveyed at the 8 University Hospital Complexes of Galicia, Spain. Results and discussion: The mean age was 52.14 years, with 50% of men. 84.21% of the ICs provided by non-medical personnel were limited to delivering and reading it. 90% of patients after signing the IC, trust their doctor. Only 50% of the professionals tried to involve the patient in DM. 53.33% of the patients participated in DM. 45.83% patients signed for having understood and accepted the explanation, being completely satisfied 95 of the patients surveyed (79.17%). Conclusions: It is essential to change the attitude of non-medical health professionals involved in the DM process, because their involvement is not being promoted. Although less than half of the respondents have signed the IC for having understood, the degree of satisfaction and confidence in the doctor was not compromised.