A paucity of literature exists linking acute extremity compartment syndrome associated with cocaine or olanzapine overdose. LJ, a 38-year male, was initially seen at an outside hospital for acute encephalopathy and le...A paucity of literature exists linking acute extremity compartment syndrome associated with cocaine or olanzapine overdose. LJ, a 38-year male, was initially seen at an outside hospital for acute encephalopathy and left lower extremity swelling shortly after cocaine and suspected olanzapine overdose. On presentation, totalcreatinine kinase levels were >1000 units/liter but quickly rose to 23,000 units/liter after 12 hours. He was transferred to a tertiary care center for surgical evaluation. Upon the exam, it was quickly determined that he had compartment syndrome and he was urgently taken to the operating room for a four-compartment lower extremity fasciotomy. Acute compartment syndrome is a limb threatening condition generally diagnosed clinically. Cocaine, a potent vasoconstrictor, is widely reported to cause rhabdomyolysis from ischemia of skeletal muscle tissue and direct toxicity to myocytes resulting in leakage of creatinine kinase. Other complications including cardiovascular, respiratory, neurological, and gastrointestinal disturbances have also been well documented. Olanzapine, an atypical antipsychotic, has also been reported to cause rhabdomyolysis. However, myositis with lower extremity compartment syndrome is a rare occurrence and requires quick diagnosis and aggressive treatment in order to achieve limb salvage. The potential causality of compartment syndrome from either cocaine, olanzapine, or both will be examined in this case report.展开更多
Wound infections can have devastating effects on healing as well as the health of the patient. Complications increase when the pathogens are capable of producing virulence factors and/or are drug resistant. Novel meth...Wound infections can have devastating effects on healing as well as the health of the patient. Complications increase when the pathogens are capable of producing virulence factors and/or are drug resistant. Novel methods are needed to take on the challenges of treating such wounds. Drawtex®?dressing is purported to have hydroconductive properties that allow it to draw away debris and exudate from the wound into the dressing. The goal of this work is to better define these interactions of this experimental dressing with bacteria and virulence factors. Two series of in vitro experiments were performed. First, pieces of experimental dressing were submerged in a series of cultures in flasks and samples of the dressing and cultures were taken over 90 minutes and assayed for bacteria and virulence factor levels. Second, experimental or standard care (control) dressings were placed on selective agar plated with pathogens of interest. Dressings and the agar covered by them were used to quantify bacteria and virulence factors over time. The experimental dressing took up both bacteria and virulence factors to a larger extent than the control dressing. Experimental dressing significantly reduced the load of bacteria and virulence factors in cultures compared to control culture without dressing. Based on the ability of the dressing to take up bacteria and virulence factors in this study, the data point to the potential for this dressing to be similarly effective in reducing or eliminating pathogen from wounds, potentially increasing the chances of successful wound healing.展开更多
文摘A paucity of literature exists linking acute extremity compartment syndrome associated with cocaine or olanzapine overdose. LJ, a 38-year male, was initially seen at an outside hospital for acute encephalopathy and left lower extremity swelling shortly after cocaine and suspected olanzapine overdose. On presentation, totalcreatinine kinase levels were >1000 units/liter but quickly rose to 23,000 units/liter after 12 hours. He was transferred to a tertiary care center for surgical evaluation. Upon the exam, it was quickly determined that he had compartment syndrome and he was urgently taken to the operating room for a four-compartment lower extremity fasciotomy. Acute compartment syndrome is a limb threatening condition generally diagnosed clinically. Cocaine, a potent vasoconstrictor, is widely reported to cause rhabdomyolysis from ischemia of skeletal muscle tissue and direct toxicity to myocytes resulting in leakage of creatinine kinase. Other complications including cardiovascular, respiratory, neurological, and gastrointestinal disturbances have also been well documented. Olanzapine, an atypical antipsychotic, has also been reported to cause rhabdomyolysis. However, myositis with lower extremity compartment syndrome is a rare occurrence and requires quick diagnosis and aggressive treatment in order to achieve limb salvage. The potential causality of compartment syndrome from either cocaine, olanzapine, or both will be examined in this case report.
文摘Wound infections can have devastating effects on healing as well as the health of the patient. Complications increase when the pathogens are capable of producing virulence factors and/or are drug resistant. Novel methods are needed to take on the challenges of treating such wounds. Drawtex®?dressing is purported to have hydroconductive properties that allow it to draw away debris and exudate from the wound into the dressing. The goal of this work is to better define these interactions of this experimental dressing with bacteria and virulence factors. Two series of in vitro experiments were performed. First, pieces of experimental dressing were submerged in a series of cultures in flasks and samples of the dressing and cultures were taken over 90 minutes and assayed for bacteria and virulence factor levels. Second, experimental or standard care (control) dressings were placed on selective agar plated with pathogens of interest. Dressings and the agar covered by them were used to quantify bacteria and virulence factors over time. The experimental dressing took up both bacteria and virulence factors to a larger extent than the control dressing. Experimental dressing significantly reduced the load of bacteria and virulence factors in cultures compared to control culture without dressing. Based on the ability of the dressing to take up bacteria and virulence factors in this study, the data point to the potential for this dressing to be similarly effective in reducing or eliminating pathogen from wounds, potentially increasing the chances of successful wound healing.
