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Chronic obstructive pulmonary disease is progressive and in its advanced stage is associated with major disability. Previous studies suggest that patients with this disease receive little palliative care, even in very advanced stages. Given this, our objectives were to describe the clinical practice of Spanish pulmonologists in the care of patients with end-stage chronic obstructive pulmonary disease, to identify potential barriers to implementing palliative care in these patients and to correlate these responses with doctor's years of experience. A link to an online survey was sent to pulmonologists on (a) symptom management, (b) structure of their department and collaboration with other services, (c) specialized medical training in palliative care, (d) communication with patients and their families, and (e) limiting barriers identified in the management of these patients. A total of 387 responses were received. The majority used opioids to treat dyspnea (52.9%) or pain (54.2%) and many treated anxiety/depression (41%). Around half of the respondents had no established routines in their departments to offer palliative care to patients with chronic obstructive pulmonary disease. There was little communication with end-of-life patients and their families on disease course, mainly associated with a lack of medical training (83% of cases) and changes in patient wishes regarding care through the disease course (81%). In our setting, communication with end-of-life patients with chronic obstructive pulmonary disease is poor. The key challenges identified are insufficient medical training and changing desires of patients. No substantial differences in attitude were found as a function of experience. [ABSTRACT FROM AUTHOR]

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The synthesis of ferrocene-based heteroditopic receptors in which the ferrocene moiety is attached to an imidazo[4,5-e]benzothiadiazole or imidazo[4,5-f]quinoxaline is reported. These nitrogen-rich ferrocene derivatives show remarkable ion-sensing properties because of the presence of the redox active ferrocene unit and the polyazaheteroaromatic ring systems which act as a dual binding site for anions and metal cations. They display an anodic shift of the oxidation wave (ΔE1/2= 67–200 mV) upon complexation with metal cations and a strong cathodic shift (ΔE1/2= −82 to −100 mV) in the presence of F−and HP2O73−anions. For the Zn2+, Cd2+, Hg2+and Pb2+metal cations tested, the change in the absorption spectra is accompanied by a dramatic colour change which allows the potential for “naked eye” detection. [ABSTRACT FROM AUTHOR]