Femoral Neck Fracture with Avascular Necrosis.

Hip fractures are common in the aging population, with complications such as avascular necrosis. We describe a case of an 85-y-old woman with early avascular necrosis as a complication from femoral neck fracture discovered on routine bone densitometry screening.

"Diffusion of innovations": a feasibility study on the pericapsular nerve group block in the emergency department for hip fractures.

OBJECTIVE: Hip fractures are associated with significant morbidity and mortality. Ultrasound-guided peripheral nerve blocks are a safe method to manage pain and decrease opioid usage. The pericapsular nerve group (PENG) block is a novel, potentially superior block because of its motor-sparing effects. Through training, simulation, and supervision, we aim to determine whether it is feasible to perform the PENG block in the emergency department. METHODS: Phase 1 consisted of emergency physicians attending a workshop to demonstrate ultrasound proficiency, anatomical understanding, and procedural competency using a low-fidelity model. Phase 2 consisted of a prospective, observational, feasibility study of 10 patients with hip fractures. Pain scores, side effects, and opioid usage data were collected. RESULTS: The median pain score at time 0 (time of block) was 9 (interquartile range [IQR], 6.5-9). The median pain score at 30 minutes was 4 (IQR, 2.0-6.8) and 3.5 (IQR, 1.0-4.8) at 4 hours. All 10 patients required narcotics prior to the initiation of the PENG block with a median dosage of 6.25 morphine milligram equivalents (MME; IQR, 4.25-7.38 MME). After the PENG block, only 30% of the patients required further narcotics with a median dosage of 0 MME (IQR, 0-0.6 MME) until operative fixation. CONCLUSION: In this feasibility study, PENG blocks were safely administered by trained emergency physicians under supervision. We demonstrated data suggesting a trend of pain relief and decreased opiate requirements, and further investigation is necessary to measure efficacy.

Phase transitions of n-hexadecane in nanoencapsulated binary solutions of n-hexadecane and 1-octanol.

Binary solutions of n-hexadecane and 1-octanol were encapsulated within poly(tert-butyl methacrylate) nanocapsules and the phase transition behavior of the n-hexadecane studied. A sigmoidal correlation was found between the binary composition of the encapsulated oil and the oil formulation prior to encapsulation. At low 1-octanol fractions in the synthesis, almost no alcohol was encapsulated, but at high 1-octanol fractions, the capsules were enriched in alcohol. The freezing point of the encapsulated n-hexadecane was considerably lower than in the bulk phase. This freezing point was further reduced as the radius of the particle was reduced, which is expected from the Gibbs-Thompson equation. The extracted value at infinite radii was, however, 14 °C below the bulk freezing point. The colligative effect of 1-octanol on the freezing point of n-hexadecane, i.e., dT(f)/dx(m), where x(m) is the mass fraction of 1-octanol, was nearly identical to that measured in the bulk system. The specific enthalpy of freezing for the encapsulated system was considerably different from the bulk system. In the bulk system, the freezing enthalpy for n-hexadecane was nearly constant up to 60% mass of 1-octanol. The freezing enthalpy for the encapsulated n-hexadecane showed greater variation with % mass 1-octanol, and had a considerably lower absolute value than the bulk system.