The direct, stereospecific amination of alkylboronic and borinic esters can be conducted by treatment of the organoboron compound with methoxyamine and potassium tert-butoxide. In addition to being stereospecific, this process also enables the direct amination of tertiary boronic esters in an efficient fashion.

The stereodivergent asymmetric hetero-Diels-Alder reaction of achiral and chiral 1 -oxa-

A direct, stereocontrolled synthesis of acyclic α-chloroenamides is presented. Our methodology showed good yields and substrate scope. Mechanistic insights are provided that account for the high levels of stereoselectivity reported. Subsequent synthetic manipulation of the α-chloroenamides provides direct entry to polyfunctionalized acyclic enamides, compounds of wide use in organic chemistry and the pharmaceutical industry.

Introduction A significant portion of intensive care unit (ICU) patients require a Foley catheter during their admission. Foley use has become more criticized as nationwide quality improvement processes attempt to reduce catheter associated urinary tract infections (CAUTI). Burn patients in the ICU have a higher rate of catheter utilization due to difficult fluid management, need for accurate volume measurements, and significant wound care. Males may have a condom catheter exchanged once they are stabilized. Historically, a noninvasive alternative to the Foley has not been available for females. While the female external catheter has existed for quite some time and hospital systems are increasingly encouraging their use, there is no standard of practice for when they are best utilized. Specific to the burn population, potential barriers include body habitus, perineal burns, and pain on frequent changing of the device. Our study aims to evaluate the current female external catheter use in our burn ICU in order to develop a standard protocol to increase utilization while thoughtfully delineating the contraindications. Methods A quality improvement project for guidelines on the use of a female external urinary collection device was conducted. All female patients admitted to the burn ICU during 2019 were included. Data was collected on burn TBSA, anatomic location, ICU days, ventilator days, and foley catheter days. Foley catheter days, external urinary catheter days, urinary tract infection (UTI) rates, and incidence of failure of external device were collected. Results Of the 46 total female burn patients, 31 required a foley catheter at some point during their stays. 11 patients used an external urinary collection device. Of the 11 users, one urinary device had to be removed due to skin breakdown. One other patient required replacement with a Foley catheter as a result of oliguria and the need for closer fluid management. 5 of the successful users of the external catheter were clinically obese. No patients contracted a UTI while using the external catheter. 3 UTI’s developed in women while using a Foley catheter. Patients who had altered mental status and perineal wounds were not eligible to use the external catheter. Conclusions In our practice, we found contraindications to external female catheter use to include altered mental status and perineal wounds. Obesity was not a contraindication and device usage may be most beneficial in incontinent patients. Further investigation is needed to better optimize female external urinary collection device usage within the burn ICU setting. This may help minimize CAUTI’s among female burn patients.

Abstract American Burn Association guidelines recommend that all pediatric burns be transferred to a burn center if their presenting hospital lacks the necessary personnel or equipment for their care. Our institution often treats small burns (<10% TBSA) in pediatric patients in an ambulatory setting with a non-daily dressing. The aim of this study was to determine if small pediatric burns could be safely managed on an outpatient basis. A retrospective review at a single ABA-verified burn center was conducted, including 742 pediatric patients presenting to the burn evaluation clinic in a three-year period. Post burn day, age, sex, TBSA, burn etiology, body area burned, burn dressing type, outpatient versus inpatient management, reason(s) for admission, and any operative intervention were collected. Overall, the most common burn etiologies were scald (68%), contact (20%), and flame (5%). In this cohort, 14% (101) of patients were admitted upon evaluation to the burn center with a mean TBSA of 9%. The remaining 86% (641) of patients were treated outpatient with a mean TBSA of 3%. Of those who were treated outpatient, 96% (613) successfully completed outpatient care and 4% (28) were subsequently admitted. The patients who were successfully managed in an ambulatory setting had a mean TBSA of 3% whereas the patients who failed outpatient care had a mean TBSA of 4%. The primary reason for subsequent admission of these patients was nutrition optimization (61%). The vast majority of small pediatric burns can be effectively treated on an outpatient basis with a non-daily dressing.