Compressibility and compactibility of granules produced by wet and dry granulation.

The bulk properties, compactibility and compressibility of granules produced by wet and dry granulation were compared applying a rotary tablet press, three different morphological forms of calcium carbonate and two particle sizes of sorbitol. Granules from both granulation methods possessed acceptable flow properties; however, the ground (Mikhart) and cubic (Scoralite) calcium carbonate demonstrated better die-filling abilities in the tablet press than the scalenhedral calcium carbonate (Sturcal). The wet processed granules showed in general larger compression properties. This was explained as these granules were mechanical stronger and had a higher initial porosity. In some cases, a large particle surface area of calcium carbonate and sorbitol resulted in a small, insignificant improvement of the consolidation characteristics. A correlation between the compression and compaction characteristics was demonstrated.

Granule fraction inhomogeneity of calcium carbonate/sorbitol in roller compacted granules.

The granule fraction inhomogeneity of roller compacted granules was examined on mixtures of three different morphologic forms of calcium carbonate and three particle sizes of sorbitol. The granule fraction inhomogeneity was determined by the distribution of the calcium carbonate in each of the 10 size fractions between 0 and 2000 microm and by calculating the demixing potential. Significant inhomogeneous occurrence of calcium carbonate in the size fractions was demonstrated, depending mostly on the particles sizes of sorbitol but also on the morphological forms of calcium carbonate. The heterogeneous distribution of calcium carbonate was related to the decrease in compactibility of roller compacted granules in comparison to the ungranulated materials. This phenomenon was explained by a mechanism where fracturing of the ribbon during granulation occurred at the weakest interparticulate bonds (the calcium carbonate: calcium carbonate bonds) and consequently exposed the weakest areas of bond formation on the surface of the granules. Accordingly, the non-uniform allocation of the interparticulate attractive forces in a tablet would cause a lowering of the compactibility. Furthermore, the ability of the powder to agglomerate in the roller compactor was demonstrated to be related to the ability of the powder to be compacted into a tablet, thus the most compactable calcium carbonate and the smallest sized sorbitol improved the homogeneity by decreasing the demixing potential.

Improving the compaction properties of roller compacted calcium carbonate.

The effects of roller compaction process parameters, morphological forms of calcium carbonate and particle size of sorbitol on flow, compaction and compression properties were investigated. The morphology of the calcium carbonate and the sorbitol particle size were more influential on the compaction properties than the settings of the roller compactor. The roller compaction process was demonstrated to be robust and stable in regard to flowability and compactibility. The flowability of the granules was improved adequately to facilitate compression in a production scale rotary tablet press. By adding sorbitol to the calcium carbonate, the compressibility - characterized by the Walker coefficient W(ID) - and the compactibility C(P) were improved considerably. A correlation between the consolidation characteristics was demonstrated. Compactibility data from the compaction simulator correlated with the tablet press for two of the calcium carbonates, the cubic form and the ground quality.

[Congenital bilateral perisylvian syndrome]. / Kongenit bilateralt perisylvant syndrom.

The congenital bilateral perisylvian syndrome is characterized by pseudobulbar palsy, moderate delay in mental and motor development and epilepsy. Three characteristic case stories are presented. Epileptic seizures are most frequently generalized: tonic, astatic, atypical absences and tonic-clonic seizures. Partial seizures are less frequent. Seizure control is often unsatisfactory. Neuroimaging demonstrates thickening of the cerebral cortex in the perisylvian area bilaterally; these changes together with the clinical picture establish the diagnosis. The etiology is unknown.

[Medication errors in a pediatric department]. / Fejlmedicinering på en børneafdeling.

In a prospective study, iatrogenic medication errors were registered among paediatric admissions. The two most common causes of incidents were neglecting to give a medication on schedule and administration of an incorrect dose-but extra dose errors, errors of omission, wrong rate errors and administration of unauthorized drugs also occurred. After implementation of a satellite pharmacy, medication error rates were compared, and a reduction of the more serious and potentially harmful incidents was shown.

Arthroscopic repair of the bucket-handle meniscus. 10 failures in 27 stable knees followed for 3 years.

In a total of 535 meniscal lesions diagnosed by arthroscopy, 54 patients had their meniscus sutured arthroscopically. 25 cases were excluded from the study due to concomitant ligamentous injury, while 2 were lost to follow-up, leaving 27 cases of arthroscopic repair of isolated bucket-handle meniscal tears for review. 8 cases had the repaired meniscus partially resected later due to recurring symptoms. The remaining 19 cases were scored for knee function and activity after a median observation time of 36 (18-52) months. 15 of 19 patients with a supposedly healed meniscus had normal knee function, i.e., unchanged compared to preinjury levels, but a slight drop in median activity score. With 8 re-ruptures and 2 patients who stated result as poor, the 10/27 failure rate was rather high. Our results are not as good as most reported previously.

[Varying clinical pictures among young children with influenza virus type A infections]. / Varierende sygdomsbilleder hos mindre børn med Influenzavirus type A infektioner.

The clinical course of Influenza type A virus infections in 47 hospitalized children aged 0-9 years was assessed retrospectively. The infection was diagnosed by demonstration of the virus in the nasopharyngeal secretion during the acute phase of the illness. Out of 21 Influenza A strains in which the subtype was determined, one was found to be H1- and 20 were H3-subtype. Lower respiratory tract disease was the main diagnosis in 21 children, 16 of whom had pneumonia; 14 of these patients were under three years of age. Gastro-intestinal symptoms occurred in 40% of the children over three years of age. Eight patients had febrile convulsions, a girl aged nine years had double vision and vertigo and a female infant aged two months had periodic apnoea and bradycardia. The reasons for hospitalization were febrile convulsions, abdominal pain, lower respiratory tract symptoms and high pyrexia.

Rupture of the knee capsule from articular hyperpressure. Experiments in cadaver knees.

We used 10 cadaver knees to estimate the safe pressure during arthroscopy by measuring the volumes and pressures of irrigation fluid at different flexion angles. Maximum volumes could be contained at 35 degrees of flexion. Pressures of 200 to 450 mmHg were measured, and all the knees ruptured by extension or flexion after they were filled to 100 mmHg at 35 degrees of flexion. Fifty milliliters of irrigation fluid had to be removed if the pressure remained constant when extending from 35 degrees and 70 ml when flexing to 90 degrees. Totally, 100 ml irrigation fluid had to be removed when flexing from 35 degrees to 120 degrees. Our investigation indicates that a pressure of 150 mmHg can be tolerated by all knees. Both flexion and extension from the 35 degrees position must be done gently and slowly using a large bore, wide-open inflow and outflow tubes allowing egress of irrigation fluid to prevent capsular rupture, extravasation of irrigation fluid, vascular compromise, or compartment syndrome.