Oral neutrophil levels, as determined by a rapid oral rinse, reflect the severity of periodontal disease and treatment response. A single, rapid, oral rinse assay is an effective means of collecting and quantifying oral neutrophil levels and may serve as an excellent research tool for further study of the role of neutrophils in periodontal diseases.

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Erythromycin lactobionate (ERY), a macrolide antibiotic, has been the focus of investigati on as a new gastrointestin al prokinetic agent. In individuals who are able-bodied (AB), ERY has shown promise in various form s of gastroparesis (GP). Recent evidence suggests th at med ica tions used to stimu late intestinal motility in individuals who are AB have had similar results in those individuals with spinal cord injury (SCI). M ed ica tions th at have been used in th e past for GP in SCI include metaclopramide, neostigmin e, and bethanechol.In thi s observation, a pati ent with T-6 para pl eg ia, who deve loped GP secondary to acute SCI, is presented. During his hosp ital stay, th e p ati ent was treated with gastric decompress ion, bowel rest, H2 blockers, intrave nous metaclopramide, and ventua ll y required parenteral nutritiona l support. ERY was started and symptom s abated. At thi s point, the nasogastri c tube was r mov d and oral feeding was success fully started. This case report is th e first to describe a pati nt with refractory SCI -induced GP who respo nded to intraveno us ERY. Further study in thi s area is warranted.

Fragility fractures are occurring at an ever-increasing rate, creating an enormous economic and societal impact. Outpatient-based fragility fracture programs have been developed to identify at-risk patients, initiate effective treatment of metabolic bone disease, and improve coordination between members of the patient's care team with the goal of reducing future fractures. Inpatient programs focus on effective, efficient management of patients presenting with acute fractures. Both have proven successful in reducing the impact of fragility fractures, but many challenges exist. The orthopedic surgeon, as part of an integrated team of providers, is integral in identifying at-risk patients, ensuring appropriate care of acute fractures, and initiating treatment protocols to reduce the risk of further injuries.

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