Caprenin is a triglyceride that contains primarily caprylic (C8:0), capric (C10:0), and behenic (C22:0) acids and modest amounts of arachidic (C20:0) and lignoceric (C24:0) acids. Using the fat-balance technique, the absorption of C20:0, C22:0, and C24:0 was measured in 20 healthy adult men and women aged 20–60 years consuming a chocolate-flavored caprenin confection. The absorption values for these very long-chain fatty acids (VLCFAs) were determined based on measurements of their dietary intake and fecal excretion during a 5-day treatment period and a 7-day posttreatment washout period after correcting for baseline excretion of VLCFAs. Each subject consumed 4.7 g C20:0, 52.8 g C22:0, and 0.84 g C24:0 from the test confection during the treatment. Absorption averaged 41.6% ± 3.6% (SEM) for C20:0, 28.8% ± 4.4% for C22:0, and 14.8% ± 3.9% for C24:0. Using a modification of the Atwater method, the physiological fuel value (caloric value) of caprenin was then calculated. This modified method takes into account the partial absorption of VLCFAs and the heat loss due to the metabolism of the medium-chain fatty acids C8:0 and C10:0. The results of this study demonstrate that the caloric value of caprenin is 5 kcal/g compared to the value of 9 kcal/g for other dietary triglycerides.

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This observational study involved sequential implementation of a multidisciplinary team, protocols, and a craniotomy pathway. Retrospective review of admissions (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017) revealed reduced craniotomy complication rates, case volume increased 73%, and hospital length of stay improved by 63%, as well as increased professional collegiality and satisfaction. A searchable craniotomy discharge summary is an important tool for continuous monitoring of quality and efficiency of care. The authors present outcomes data, including craniotomy indications, operative timing, complications, functional outcomes, delays in discharge, and discharge destinations using the craniotomy discharge summary.

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