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Background Hip fractures in older adults often lead to adverse health outcomes, which may be related to time to surgery and longer hospital stays. The experience of older adults with hip fractures in New Brunswick is not known. Methods This was a retrospective observational study. All hip fracture patients 65 years of age and older admitted to one hospital designated as a Level One Trauma Centre between April 1, 2015 and March 31, 2019 comprised the sample. Results The majority (86.5%) received surgery within 48 hours and those who had surgery beyond this time frame had a significantly longer stay in acute care (OR: 3.79, 95% CI: 2.05-7.15). The mean total length of stay (Total-LOS) for patients discharged after their acute care needs were met was 9.8 days (SD=8.1) compared to patients experiencing delays in discharge for nonmedical reasons which was 26.3 days (SD=33.7). An extended stay in acute care (OR: 1.93, 95% CI: 1.09-3.43) and increasing age (OR: 1.03, 95% CI: 1.001-1.06) were associated with a higher likelihood of death at one year post-discharge. Time to surgery beyond 24 hours (OR: 2.80, 95% CI: 1.13-7.38) was associated with a higher likelihood of death 30 days post-discharge. Conclusions Most patients had surgery within the national benchmark of less than 48 hours. The Total-LOS increased 2.5-fold in patients who remained in hospital after their acute care needs were met. A better understanding of patient characteristics, such as frailty, may better predict patients at risk for longer hospital stays and adverse health outcomes. [ABSTRACT FROM AUTHOR]

Background: Heart failure with reduced ejection fraction (HFrEF) is a progressive disease with high rates of hospitalization and mortality. The Canadian Cardiovascular Society recommends treating patients with HFrEF with medications from 4 standard medication classes—this is known as guideline-directed medical therapy (GDMT). However, despite clear evidence and recommendations, GDMT agents are known to be underutilized in the HFrEF population. Objective: To determine if the implementation of a prescriber-alert stewardship tool for hospitalized patients with HFrEF will increase the frequency of GDMT prescribing with all classes during hospitalization. Methods: Utilization of GDMT in patients with HFrEF between admission and discharge pre- and post-implementation of a prescriber alert stewardship tool was compared. Patients admitted to a cardiology stepdown unit between January and April 2022 had a stewardship-alert tool placed on their chart for physician review, while those admitted during the same time frame 1 year prior did not. Results: Following the use of a prescriber alert, there was a statistically significant increase in prescribing for β-blockers (38.1% to 95.2%; p < 0.001), mineralocorticoid receptor antagonists (9.5% to 66.7%; p < 0.001) and combination GDMT (9.5% to 52.4%; p = 0.004) from admission to discharge. A statistically significant increase in the prescribing of β-blockers (47.6% to 76.2%; p = 0.004) and angiotensin-converting enzyme inhibitors (21.4% to 40.5%; p = 0.008) was still observed without the use of the prescriber alert. Conclusion: A pharmacist-led heart failure stewardship tool initiative increased uptake of GDMT in patients with HFrEF. [ABSTRACT FROM AUTHOR]

The Pictorial Fit-Frail Scale (PFFS) is a frailty tool consisting of visual images to comprehensively assess frailty across 14 domains that can be completed by health professionals, patients, or caregivers. The objective of this study was to explore the feasibility of using the PFFS retrospectively to determine a patient's frailty level using data from the hospital electronic health records (EHRs) of older adults admitted with an isolated hip fracture. A random sample of 200 hip fracture patients admitted to a Level 1 Trauma Center hospital in New Brunswick was selected for review using the PFFS. The majority (94.5%) of hospital EHRs contained the clinical information needed to populate most of the 14 PFFS domains, allowing for determination of a frailty score. The mean raw PFFS frailty score was 9.7 (SD 6.6), consistent with moderate frailty. For all patients, a Frailty Index (FI) score was calculated, with the mean being 0.27 (SD 0.18), again consistent with moderate frailty. Comparing the PFFS score to the FI score, the percentage categorized as not frail or very mildly frail fell from 33.3% to 20.1%, and those considered severely frail rose from 30.7% to 34.9%. The PFFS can be successfully used retrospectively with hospital EHRs to determine the frailty level of older patients. When converted to the FI score, there was an increase in the frequency and severity of frailty. This tool may provide a useful way to stratify older adults by frailty that can be helpful in evaluating health outcomes based on frailty levels. [ABSTRACT FROM AUTHOR]

Ten lipophilic amines were prepared from the reductive amination of vanillin and the corresponding primary amines using sodium borohydride in methanol. All compounds have been obtained elementally pure and an X-ray diffraction study on the 4-n-butylaniline derivative has confirmed the molecular structure. Whilst the overall antibiotic activity of the derivatives was low, some of these compounds, particularly the boronate ester 2-methoxy-4-((2-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenylamino)methyl)phenol (7), showed a promising degree of antimycobacterial activity against Mycobacterium tuberculosis H37Ra, where activity seemed to vary by the position of the boron substitution on the aniline ring. Key words: aliphatic amines, antimicrobial, antimycobacterial, boronate esters, lipophilic, tuberculosis. Nous avons prepare dix amines lipophiles par amination reductrice de la vanilline avec les amines primaires correspondantes a l'aide du borohydrate de sodium dans le methanol. La purete des composes obtenus a ete verifiee par analyse elementaire, et une etude par diffraction des rayons X du derive 4-n-butylaniline a permis de confirmer la structure moleculaire. Bien que l'activite antibiotique des derives ait ete faible, certains de ces composes, en particulier l'ester boronique 2-methoxy-4-([2-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenylamino]methyl)phenol (7), a fait preuve, dans une mesure prometteuse, d'une activite antimycobacterienne contre Mycobacterium tuberculosis H37Ra, ou l'activite semblait varier selon la position du substituant de bore sur le noyau aniline. [Traduit par la Redaction] Mots-cles: amines aliphatiques, agent antimicrobien, agent antimycobacterien, esters boroniques, lipophile, tuberculose., Introduction Although organoboron compounds, particularly boronic acids [RB[(OH).sub.2]] and boronate esters [RB[(OR').sub.2]], are ubiquitous in organic synthesis, (1,2) recent research has also found that these same small molecules can display [...]

Eight lipophilic 3-hydroxy-4-pyridinones have been prepared from a microwave-mediated reaction along with the corresponding copper(II) complexes. All complexes have been obtained elementally pure and X-ray diffraction studies on two of the copper complexes have confirmed the structure of these compounds. Some of these complexes showed a promising degree of anti-mycobacterial activity against Mycobacterium tuberculosis, where activity seemed to vary by substitution at the pyridinone nitrogen atom. Key words: aliphatic amines, anti-mycobacterial, copper, hydroxypyridinones, lipophilic, tuberculosis. Huit 3-hydroxy-4-pyridinones lipophiles et leurs complexes du cuivre(II) correspondants ont ete synthetises lors d'une reaction provoquee par des micro-ondes. Tous les complexes ont ete obtenus sous leur forme pure et des analyses diffractometriques aux rayons X des deux complexes du cuivre ont confirme la structure de ces composes. Certains de ces complexes ont presente un niveau prometteur d'activite antimycobacterienne contre Mycobacterium tuberculosis, cette activite semblant varier par substitution au niveau de l'atome d'azote de la pyridinone. [Traduit par la Redaction] Mots-cles: amines aliphatiques, antimycobacterien, cuivre, hydroxypyridinones, lipophile, tuberculose., Introduction All but forgotten in some societies, tuberculosis remains a serious infectious disease and is the leading cause of death in most of the developing countries around the world. Indeed, [...]

The COVID-19 pandemic required pharmacists in a provincial Home Dialysis Clinic to adapt from in-person to telephone-based medication reviews. Studies have shown that in-person pharmacist interventions in patients with chronic kidney disease (CKD) lead to a reduction of drug therapy problems (DTPs), however, it's unknown if telephone interventions provide similar outcomes. The purpose of this study was to evaluate whether differences in quality of care exist between in-person vs. telephone medication reviews in home dialysis patients and to evaluate patient satisfaction with telephone medication reviews. Data from the two most recent in-person medication reviews was compared with the two most recent telephone medication reviews for each patient (n = 46). There were no statistically significant differences in DTPs identified between in-person and telephone medication reviews (p = 0.431). Physician acceptance of pharmacist recommendations was higher for in-person medication reviews (p = 0.009). Patients were satisfied with the care they received with pharmacist-led telephone medication reviews, however, 29% (n = 7) would prefer an in-person medication review once per year with telephone medication reviews the rest of the time. Overall, patients were satisfied with the care they received from telephone medication reviews. [ABSTRACT FROM AUTHOR]

Two new lipopeptaibols, tolypocaibols A ( 1 ) and B ( 2 ), and the mixed NRPS-polyketide-shikimate natural product maximiscin [( P / M )- 3 )] were isolated from a Tolypocladium sp. fungal endophyte of the marine alga Spongomorpha arcta . Analysis of NMR and mass spectrometry data revealed the amino acid sequences of the lipopeptaibols, which both comprise 11 residues with a valinol C-terminus and a decanoyl acyl chain at the N-terminus. The configuration of the amino acids was determined by Marfey's analysis. Tolypocaibols A ( 1 ) and B ( 2 ) showed moderate, selective inhibition against Gram-positive and acid-fast bacterial strains, while maximiscin [( P / M )- 3 )] showed moderate, broad-spectrum antibiotic activity.

As the need for new and more effective antibiotics increases, untapped sources of biodiversity are being explored in an effort to provide lead structures for drug discovery. Endophytic fungi from marine macroalgae have been identified as a potential source of biologically active natural products, although data to support this is limited. To assess the antibiotic potential of temperate macroalgal endophytes we isolated endophytic fungi from algae collected in the Bay of Fundy, Canada and screened fungal extracts for the presence of antimicrobial compounds. A total of 79 endophytes were isolated from 7 species of red, 4 species of brown, and 3 species of green algae. Twenty of the endophytes were identified to the genus or species level, with the remaining isolates designated codes according to their morphology. Bioactivity screening assays performed on extracts of the fermentation broths and mycelia of the isolates revealed that 43 endophytes exhibited antibacterial activity, with 32 displaying antifungal activity. Endophytic fungi from Bay of Fundy macroalgae therefore represent a significant source of antibiotic natural products and warrant further detailed investigation., Competing Interests: The authors declare no conflict of interest.