ABSTRACT
A quick and accurate diagnosis of maladies affecting the central nervous system (CNS) is imperative. Procurement and analysis of cerebrospinal fluid (CSF) are paramount in helping the clinician determine a patient's clinical condition. Various staining methods, measurement of white blood cell counts, glucose and protein levels, recognition of xanthochromia, and microbiologic studies are CSF parameters that are collectively important in the ultimate determination by a clinician of the presence or absence of a catastrophic CNS condition. Many of these CNS parameters have significant limitations that should be recognized to minimize under treating patients with catastrophic illness.
Subject(s)
Cerebrospinal Fluid/physiology , Emergency Medicine , Laboratories, Hospital , Bacterial Infections/cerebrospinal fluid , Glucose/cerebrospinal fluid , Humans , Laboratories, Hospital/economics , Laboratories, Hospital/organization & administration , Mycoses/cerebrospinal fluid , Polymerase Chain Reaction , Time FactorsABSTRACT
A brief review of the literature concerning the wound healing process is presented. A synopsis of the physical and physiologic factors that can affect the rate of this process is provided. The authors discuss the importance of the wound dressing in maintaining an optimal environment for wound healing. Modern dressings have specific indications and are frequently comprised of more than one layer. The authors define the contact layers as the layer that comes into intimate contact with the wound surface and has the greatest influence on healing. A description of some of the common products used as the contact layer is presented.
Subject(s)
Bandages , Foot/surgery , Wound Healing , Wounds and Injuries/physiopathology , Wounds and Injuries/therapy , Bandages/classification , Foot/physiopathology , Humans , Wound Healing/drug effects , Wound Healing/physiologyABSTRACT
Surgical repair of an acute, distal, tendo Achillis rupture in a 59-year-old diabetic male is described in which the Mitek Anchor System was used. The injury described is a distal tear of the insertion of the tendon into the calcaneus without avulsion fracture of the calcaneus. Sixteen months of postoperative follow-up care, including casting for equinus deformity, progressive weightbearing, range of motion exercises, and physical therapy, have been free of complications. The authors include a brief overview of historical and current reparative techniques for comparison. The authors conclude that the use of the Mitek Anchor System affords the surgeon a simple and effective method for the repair of acute, distal, tendo Achillis rupture when other methods cannot be used because of the location of the rupture.
