Limited Blood Transfusions Are Safe in Orthopaedic Trauma Patients.

Objectives: Controversy exists over association of blood transfusions with complications. The purpose was to assess effects of limited transfusions on complication rates and hospital course.

Setting: Level 1 trauma center.

Is Early Appropriate Care of axial and femoral fractures appropriate in multiply-injured elderly trauma patients?

Background: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications.

Methods: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied.

Early Appropriate Care: A Protocol to Standardize Resuscitation Assessment and to Expedite Fracture Care Reduces Hospital Stay and Enhances Revenue.

Objectives: We hypothesized that a standardized protocol for fracture care would enhance revenue by reducing complications and length of stay.

Design: Prospective consecutive series.

Setting: Level 1 trauma center.

Complications are reduced with a protocol to standardize timing of fixation based on response to resuscitation.

Background: Our group developed a protocol, entitled Early Appropriate Care (EAC), to determine timing of definitive fracture fixation based on presence and severity of metabolic acidosis. We hypothesized that utilization of EAC would result in fewer complications than a historical cohort and that EAC patients with definitive fixation within 36 h would have fewer complications than those treated at a later time.

Methods: Three hundred thirty-five patients with mean age 39.

Teamwork in Trauma: System Adjustment to a Protocol for the Management of Multiply Injured Patients.

Objectives: We developed a protocol to determine the timing of definitive fracture care based on the adequacy of resuscitation. Inception of this project required a multidisciplinary group, including physicians from anesthesiology, general trauma and critical care, neurosurgery, orthopaedic spine, and orthopaedic trauma. The purposes of this study were to review our initial experience with adherence to protocol recommendations and to assess barriers to implementation.

Obesity Is Associated With More Complications and Longer Hospital Stays After Orthopaedic Trauma.

Objective: The objective of this study was to characterize relationships between obesity and initial hospital stay, including complications, in patients with multiple system trauma and surgically treated fractures.

Design: Prospective, observational.

Setting: Level 1 trauma center.

Nanosized particles of orlistat with enhanced in vitro dissolution rate and lipase inhibition.

Orlistat is locally acting inhibitor of gastrointestinal lipases which has been developed for the treatment of obesity. The present study was designed with the intent to formulate orlistat in a different way compared to the current practice and investigate its inhibition of gastrointestinal lipases. Orlistat is considered as a technologically problematic and unmanageable substance because of waxy nature, low melting point and low chemical stability.

Advantages of celecoxib nanosuspension formulation and transformation into tablets.

Drugs with low aqueous solubility and high permeability (BCS class II) present a high proportion of all drugs. This study examines the critical issues regarding engineering of a nanosuspension tailored to increase drug dissolution rate and its transformation into dry powder suitable for tabletting. Nanosuspensions of celecoxib, a selective COX-2 inhibitor with low water solubility, were produced by the emulsion-diffusion method using three different stabilizers (Tween) 80, PVP K-30 and SDS) and characterized by particle size analysis, dissolution testing, scanning electron microscopy imaging, differential scanning calorimetry and X-ray powder diffraction.

[Detection of hydrodynamically operative tissue in the substantia spongiosa of the femoral head in Bos taurus and Ovis aries].

The authors show the presence of CC-Tensulae in Bos taurus and Ovis aries. They define CC-Tensulae as tense membranes in openings between the trabeculae of spongy bone. These structures were interpreted in man as a hydrodynamic subsystem which serves the flow and the impulses of mechanical forces.