Is a Single Entry Training Scheme for Intensive Care Medicine Both Inevitable and Desirable?

Mini-tablets as technological strategy for modified release of morphine sulfate

The aim of this study was to use intelligent formulation design for development of mini-tablets for modified release of morphine sulfate. A formulation (F1) was proposed using the Hiperstart® software. Based on the suggested formulation, two other formulations (F2 and F3) were prepared: one for modified and another for immediate drug release. The powders were characterized as bulk and tapped density, Hausner's factor and compressibility index analyzes. Mini-tablets were directly compressed and characterized as hardness, friability, size, and weight variation. The in vitro drug release profile was carried out according to the apparatus 1 of USP. Formulations showed good flow properties, and the mini-tablets displayed characteristics according to the specified. In comparison to F3 (immediate release), F1 and F2 displayed slower drug release time, showing the efficiency of the matrix formed. F3 displayed 90% of drug released up to 10 min, while F1 and F2 required 240 min. The results highlight the importance to use intelligent formulation design for the development of improved mini-tablet matrices. Formulation F1 was found to be suitable for modified morphine sulfate release. Further studies with more formulations are necessary for production of optimized mini-tablets with suitable prolonged morphine sulfate release.

The Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine

The role of the critical care specialist has been unequivocally established in the management of severely ill patients throughout the world. Data show that the presence of a critical care specialist in the intensive care unit (ICU) environment has reduced morbidity and mortality, improved patient safety, and reduced length of stay and costs. However, many ICUs across the world function as "open ICUs," in which patients may be admitted under a primary physician who has not been trained in critical care medicine. Although the concept of the ICU has gained widespread acceptance amongst medical professionals, hospital administrators and the general public; recognition and the need for doctors specializing in intensive care medicine has lagged behind. The curriculum to ensure appropriate training around the world is diverse but should ideally meet some minimum standards. The World Federation of Societies of Intensive and Critical Care Medicine has set up a task force to address issues concerning the training, functions, roles, and responsibilities of an ICU specialist.