We also evaluated the effect of patient

sex, releasing the tourniquet in knee arthroplasty and the turnover of house staff.\n\nMethods: Using our hospital transfusion database, we prospectively Quisinostat Epigenetics inhibitor studied the mean reduction in hemoglobin and transfusion rates of 1642 consecutive patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) between January 2004 and December 2005. In 2004, warfarin was used exclusively for VTE prevention; however, in 2005, following the release of the 2004 American College of Chest Physicians’ guidelines, our centre began using dalteparin for VTE prophylaxis. We analyzed the impact of dalteparin use and the effect of patient sex, tourniquet release in TKA and house staff turnover months Selleck 4-Hydroxytamoxifen on blood loss and transfusion rates.\n\nResults: The use of dalteparin for postoperative VTE prevention in patients undergoing THA and TKA in 2005 was associated with a significantly

greater mean reduction in hemoglobin compared with warfarin use in 2004 (p = 0.014 for patients undergoing THA, p < 0.001 for patients undergoing TKA). The use of dalteparin in 2005 was not associated with a significant increase in allogeneic blood transfusions compared with the use of warfarin in 2004, except in women (p < 0.001). Although we observed no significant differences in mean reduction in hemoglobin between men and women undergoing THA, women undergoing THA had significantly higher transfusion rates regardless of the method of VTE prophylaxis (p = 0.037 for warfarin, p < 0.001 for dalteparin). Intraoperative tourniquet release in patients undergoing TKA was associated with a significantly lower mean reduction in hemoglobin than release after wound closure (p = 0.005). Although house staff GSK2879552 purchase turnover months were associated with a significantly greater mean reduction in hemoglobin levels than non-turnover months (p = 0.039), these months were not associated with a significant increase

in allogeneic blood transfusions (p = 0.59).\n\nConclusion: Low molecular weight heparins such as dalteparin are the most common form of VTE prophylaxis in Canada. Our results suggest that dalteparin use, timing of tourniquet release and house staff turnover can all influence transfusion rates and/or blood loss in patients undergoing primary total joint arthroplasty. This study also emphasizes that women undergoing THA are at particularly high risk for blood transfusion.”
“Using portable, non-destructive own developed chambers (d=60 cm) and infrared gas analyses, the in situ field investigation was performed to study the seasonal and inter-annual dynamics of the stand level CO2-flux and production of sandy grassland that has been extensively grazed for decades.