RESUMO
This tutorial review--which should particularly appeal to chemists, biochemists, and molecular biologists interested in catalysis, redox processes, and enzymology--summarizes the recent progress toward developing catalysts capable of destroying one or more of the classical chemical warfare agents under ambient conditions. Specifically, we explore the reactions of sulfur mustard, the G-series of organophosphorus nerve agents including sarin and soman, and the organophosphorus nerve agent, VX. Catalysts range from metal-centered oxidation catalysts to engineered catalytic antibodies.
RESUMO
BACKGROUND: There are few data describing successful institutional "conversion" from open colectomy/standard care techniques to laparoscopic colectomy/fast-track care. PURPOSE: To assess the benefits of transitioning an institution from open to laparoscopic colectomy with fast-track care while avoiding a learning curve. METHOD: Twenty consecutive laparoscopic colorectal resections (LCRs) performed by a colorectal surgeon were compared with 20 matched open colorectal resections (OCRs) performed by general surgeons before the arrival of the colorectal surgeon. RESULTS: Surgical procedures were as follows: sigmoidectomy: OCR 16 and LCR 11; right colectomy: OCR 3 and LCR 8; and total colectomy: OCR 1 and LCR 1. The mean operative time for sigmoidectomy was 250 and 109 minutes for OCR and LCR, respectively, and for right colectomy 181 and 97 minutes for OCR and LCR, respectively (P < .001). Morbidity was OCR 45% versus LCR 25%. There was no mortality. LCR showed significantly lower length of stay and direct cost (3.6 vs. 8.3 days; 4,993 dollars vs. 11,383 dollars; both P < .001). CONCLUSIONS: The data clearly show an institutional benefit for the implementation of specialty-based advanced laparoscopic procedures.
