“
“BACKGROUND: Regionalization of trauma care reduces mortality and has clear guidelines for transport to the highest level of trauma care. Whether prehospital providers follow the CDC triage algorithm remains to be determined.\n\nSTUDY DESIGN: We performed a 5-year retrospective cohort analysis of linked data from Washington State’s Central Region Trauma Registry

(CRTR) and King County Selleckchem Thiazovivin Emergency Medical Services (KCEMS). Patients were analyzed based on transport to their designated hospital, as determined by geocode mapping, or directly to the level I center (no level II center is available in this region).\n\nRESULTS: Of the 12,106 patients in the study, 5,976 (49.4%) were transported directly to a level I center from the scene. Of the remaining 6,130 patients initially transported to level III to V centers, 5,024 (41.5%) remained in the respective level III to V centers and 1,106 (9.1%) were transferred to the level I center. Patients transported directly to GSK-3 inhibitor a level I center were more likely to be male, younger, have a penetrating injury, lower scene Glasgow Coma Scale (GCS), lower scene blood pressure, and be more severely injured. Level I direct scene transport was significantly less likely for older patients. Compared with patients ages 18 to 45, the adjusted

odds ratio for direct transport to the level I center was 0.7 (95% CI 0.59 to 0.83) for patients aged 46 to 55 years; 0.47 (95% CI 0.39 to 0.57) for those 56 to 65 years; 0.28 (95% CI 0.23 to 0.34) for patients 66 to 80 years; and 0.11 (95% CI 0.09 to 0.14) for those older than 81 years.\n\nCONCLUSIONS: Prehospital providers follow physiologic, anatomic, HDAC inhibitor mechanism and mechanistic parameters in steps 1 to 3 of the CDC field triage guidelines. However, contrary to the special considerations guideline

in step 4, older age was associated with transport to the lower level of trauma care in our region. (J Am Coll Surg 2012; 215: 148-156. (C) 2012 by the American College of Surgeons)”
“Osteoporosis is a common disease with wide prevalence, especially in the elderly population. Osteoporosis induced fractures not only decrease the patient’s life quality, but also cause heavy financial burden to the society. Although current medications for osteoporosis are effective, numerous adverse effects have been observed accompanying their clinical applications. Effective prevention and therapy strategies with high safety are critical, which benefit both individual patients and the whole society. Traditional Chinese medicines have been used for thousands of years to treat bone related diseases in China and a number of modern preparations have been developed that are currently commercially available. In addition, several medicinal herbs demonstrated therapeutic effects against osteoporosis in animal models.