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Related Concept Videos

Radical Reactivity: Nucleophilic Radicals01:16

Radical Reactivity: Nucleophilic Radicals

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Radicals adjacent to electron-donating groups are called nucleophilic radicals. These radicals readily react with electrophilic alkenes. The SOMO–LUMO interactions are the driving force for the reaction, where the high-energy SOMO of the electron-rich, nucleophilic radicals interacts with the low-energy LUMO of the electron-deficient, electrophilic alkenes. Such SOMO–LUMO interactions are the basis of reactive radical traps, affecting the selectivity in radical reactions. For...
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Radical Reactivity: Electrophilic Radicals01:02

Radical Reactivity: Electrophilic Radicals

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Radicals adjacent to electron‐withdrawing groups are called electrophilic radicals. These radicals readily react with nucleophilic alkenes. For example, the malonate radical, in which the radical center is flanked by two electron‐withdrawing groups, reacts readily with butyl vinyl ether, which consists of an electron‐donating oxygen substituent. The reaction between electrophilic malonate radical and nucleophilic vinyl ether is favored because the radical has a...
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Radical Autoxidation01:20

Radical Autoxidation

3.2K
The oxidation of an organic compound in the presence of air or oxygen is called autoxidation. For example, cumene reacts with oxygen to form hydroperoxide. Autoxidation involves initiation, propagation, and termination steps. Many organic compounds are susceptible to autoxidation—especially ethers in the presence of oxygen, which form hydroperoxides. Even though this reaction is slow, old ether bottles contain small amounts of peroxide, which leads to laboratory explosions during ether...
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Radical Formation: Overview01:03

Radical Formation: Overview

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A bond can be broken either by heterolytic bond cleavage to form ions or homolytic bond cleavage to yield radicals. A fishhook arrow is used to represent the motion of a single electron in homolytic bond cleavage. There are two main sources from which radicals can be formed:
Radicals from spin-paired molecules:
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Radical Formation: Homolysis00:54

Radical Formation: Homolysis

4.5K
A bond is formed between two atoms by sharing two electrons. When this bond is broken by supplying sufficient energy, either two electrons can be taken up by one atom forming ions by the cleavage called heterolysis, or the two electrons are shared by two atoms, with one each creating radicals by the cleavage called homolysis.
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Radical Formation: Addition00:47

Radical Formation: Addition

2.3K
Radicals can be formed by adding a radical to a spin-paired molecule. This is typically observed with unsaturated species, where the addition of a radical across the π bond leads to the production of a new radical by dissolving the π bond. For example, the addition of a Br radical to an alkene yields a carbon-centered radical.
Similar to charge conservation in chemical reactions, spin conservation is implicit for radical reactions. Accordingly, the product formed must possess an...
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Outpatient Robot-assisted Radical Prostatectomy: A Feasibility Study.

Doria Congnard1, Sébastien Vincendeau2, Ahmed Lahjaouzi3

  • 1Univ Rennes, INSERM, INRA, CHU Rennes, CIC 1414, Numecan, Pole Anesthésie et Reanimation, F-35033 Rennes, France.

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Routine outpatient management after robotic-assisted radical prostatectomy (RARP) is not yet feasible for most patients. However, discharge on postoperative day 1 appears achievable with improved management of nausea and vomiting.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Anesthesiology

Background:

  • Prostate cancer is a leading cancer in men, with surgical techniques evolving towards less invasive robotic-assisted radical prostatectomy (RARP).
  • Advancements in surgical and anesthetic techniques have paved the way for exploring outpatient procedures, including RARP.

Purpose of the Study:

  • To assess the feasibility of routine outpatient management following robotic-assisted radical prostatectomy.
  • To identify potential risk factors for delayed discharge after RARP.

Main Methods:

  • An observational, prospective, monocentric study included 97 patients undergoing RARP by a single experienced surgeon.
  • Discharge readiness was evaluated using the Post Anesthesia Discharge Scoring System (PADSS), aiming for a score of 9 or higher.
  • Risk factors for delayed discharge were secondarily analyzed.

Main Results:

  • Only 1 patient met discharge criteria on the day of surgery (day 0).
  • 74% of patients achieved discharge criteria by postoperative day 1, with 33% and 66% discharged by days 2 and 3, respectively.
  • Patients discharged on day 1 reported significantly less postoperative nausea and vomiting compared to those discharged later (7% vs. 28%, P=.01).

Conclusions:

  • Routine outpatient management is not currently feasible for the majority of patients undergoing RARP.
  • Discharge on postoperative day 1 is a conceivable goal, particularly with effective management of postoperative nausea and vomiting.
  • Further research is needed to confirm the potential for outpatient RARP and optimize patient selection and care pathways.