Introduction of a Pre-admission Pharmacist Service Utilising the Surgical Ward Pharmacist.

Background: The challenge with obtaining a best possible medication history (BPMH) post-surgery is the delay in clarifying medications due to decreased post-operative cognitive status and pain, which can lead to missed or late administration of medications. Studies have suggested that unintentional medication discrepancies at the time of admission are common in general medical patients. Objectives: To investigate if a pre-admission pharmacist completing BPMHs for adult elective surgery patients with planned overnight admission increases the proportion of patients with (i) a BPMH completed, (ii) medication reconciliation completed and (iii) all home medications charted correctly within 24 hours of admission. Methods: Patients in the pre-intervention group had a BPMH completed on admission as standard of care. Patients in the post-intervention group were contacted by the pre-admission pharmacist 1 to 3 business days prior to admission to complete a BPMH. The pre-admission pharmacist role was performed by a surgical ward pharmacist in addition to their daily workload. Descriptive statistics, Chi-squared test and Mann-Whitney U test were used to analyse the data. Results: The post-intervention group had more patients with a completed BPMH (47.2% vs 25.3%, P = .005), medication reconciliation (43.8% vs 15.5%, P = .0001) and all home medications charted correctly (36% vs 16.9%, P = .007) within 24 hours of admission compared with the pre-intervention group. Conclusion: The introduction of a pre-admission service utilising the surgical ward pharmacist increased the proportion of patients with a completed BPMH, medication reconciliation and home medications charted correctly within 24 hours of admission.

The Fate of the Shoulder Post Rotator Cuff Repair: Biomechanical Properties of the Supraspinatus Tendon and Surrounding Structures.

The study aimed to describe the changes in biomechanical properties of the supraspinatus tendon, deltoid muscle, and humeral head post arthroscopic rotator cuff repair using shear wave elastography. Shear wave velocity of the tendon, deltoid, and humeral head of 48 patients was measured at predetermined sites at 1 week, 6 weeks, 12 weeks, 6 months, and 12 months post repair. One-way ANOVA with Tukey's correction and Spearman's correlation were performed. Mean±SEM healing tendon stiffness, adjacent to tendon footprint, increased from 1 week (6.2±0.2 m/s) to 6 months (7.5±0.3 m/s) and 12 months (7.8±0.3 m/s) (P<0.001). Mean±SEM deltoid muscle stiffness was higher at 12 months (4.1±0.2 m/s) compared to 1 week (3.4±0.1 m/s) and 12 weeks (3.5±0.1 m/s) (P<0.05). Humeral head stiffness did not change. Following arthroscopic rotator cuff repair, supraspinatus tendon stiffness increased in a curvilinear fashion over 6 months. From 6 months, deltoid muscle stiffness increased, corresponding to when patients were instructed to return to normal activities.

First atroposelective Chan-Lam coupling for the synthesis of C-N linked biaryls.

The first atroposelective Chan-Lam coupling for the synthesis of C-N axial enantiomers is reported with good yields and ee. MnO2 additive is crucial for the success of the coupling. The longstanding problem of the lack of enantioselective synthesis to make chiral C-N linked atropisomers is solved.