Objective:
It has been well documented in various studies that individuals who sustain orthopaedic trauma are more likely to develop post-traumatic stress disorder (PTSD). The objective of our study is to assess the current literature regarding the use of propranolol for the treatment of PTSD and deliberate its use for patients who have sustained orthopaedic trauma.
Conclusion:
Although early studies show beneficial outcomes for patients treated with propranolol to prevent the progression of PTSD, these studies have limited sample sizes. We do not recommend the use of propranolol at this time; however, as more research emerges, it is likely that it may become a reliable option for treating patients in the future. We encourage orthopaedic providers to be cognizant of not only the physical injuries sustained in trauma but also the overall mental health of their patients. We recommend that patients who may be suffering from PTSD are referred to the appropriate psychiatric or mental health professional who can treat patients with cognitive behavioral therapy or with other pharmacological options. Further studies are also needed to investigate the effects of PTSD on outcomes in orthopaedic surgery.
There exist many industrial processes in which it is necessary to remove a gelled material from a duct. Some examples include mud removal in oil and gas well cementing, waxy crude oil pipeline restarts, and Enhanced Oil Recovery (EOR). Here, the dynamics of the removal of a viscoplastic fluid by a Newtonian fluid are investigated experimentally in an inclined pipe. We focus on both miscible and immiscible fluids mimicking wells drilled using water-based as well as oil-based mud. Under the miscible limit two major flow regimes, namely center-type and slump-type, are observed depending on the density difference between fluids. These flows are explored in great details through displacement front speed measurement which is inversely related to the efficiency of removal process. Displacement flows in the immiscible limit are accompanied by interfacial instability, gel fracture, and droplet formation. These flows are quantified through flow visualisation and spatiotemporal diagrams of fluids concentration. The findings of our study can help improve well cementing operations worldwide.
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