MACROCYCLIC LIGAND RING SIZE EFFECTS .2. SYNTHETIC, STRUCTURAL AND ELECTROCHEMICAL STUDIES OF THE INTERACTION OF NI-2 WITH 14-MEMBERED TETRAAZA MACROCYCLES CONTAINING FUSED DIBENZO SUBSTITUENTS

A comparative study of the high- and low-spin complexes of Ni(II) with two tetraaza dibenzo-substituted macrocycles incorporating 14-membered inner rings has been carried out. The results obtained are also compared with those for the analogous nickel(II) derivatives of 1,4,8,11-tetraazacyclotetradecane. Four X-ray structures of nickel complexes as well as the structure of one free ligand have been determined. These structures taken together with previous X-ray structural data and selected molecular mechanics calculations have enabled a detailed assessment of the effects of spin state and ligand substituent on the hole size and ring conformations adopted by individual complexes. A comparative electrochemical investigation of individual high- and low-spin complexes in the series has been performed

Perioperative Care of Children with Severe Neurological Impairment and Neuromuscular Scoliosis—A Practical Pathway to Optimize Peri-Operative Health and Guide Decision Making

Neuromuscular scoliosis is a common feature in children with severe neurological impairment (SNI), including those with severe cerebral palsy. Surgical correction of scoliosis is the mainstay of treatment. This group of patients also have associated medical complexity. The complication rates post-surgery are high, although, for many, they are worth the risk. There are currently no published practice guidelines or care pathways for children with SNI who are undergoing scoliosis corrective surgery. In response to the high uptake of this surgery, coupled with the expected complication rates, our hospital established a perioperative clinic. The purpose of this paper is to describe our perioperative approach. This clinic has developed into a service beyond perioperative care and, with the collaborative meeting, enables shared decision-making to identify the right candidate for surgery. The process involves surgical expertise, understanding the family and child at the centre, and optimisation of medical care pre- and post-surgery. In this paper, we describe the process in a step-by-step manner. We provide clinical vignettes, as well as the proformas that we use, and we highlight the benefits of the team-based process