Cerebral fat embolism with turbid urine as the initial sign.

BACKGROUND: Cerebral fat embolism (CFE) is a rare but potentially fatal complication that can occur after long bone fractures. It represents one subcategory of fat embolisms (FE). Diagnosing CFE can be challenging due to its variable and nonspecific clinical manifestations. We report a case of CFE initially presenting with turbid urine, highlighting an often neglected sign. CASE PRESENTATION: A 69-year-old male was admitted after a traffic accident resulting in bilateral femoral fractures. Sixteen hours post-admission, grossly turbid urine was noted but received no special attention. Four hours later, he developed rapid deterioration of consciousness and respiratory distress. Neurological examination revealed increased upper limb muscle tone and absent voluntary movements of lower limbs. Brain MRI demonstrated a 'starfield pattern' of diffuse punctate lesions, pathognomonic for CFE. Urine microscopy confirmed abundant fat droplets. Supportive treatment and fracture fixation were performed. The patient regained consciousness after 3 months but had residual dysphasia and limb dyskinesia. CONCLUSION: CFE can present with isolated lipiduria preceding overt neurological or respiratory manifestations. Heightened awareness of this subtle sign in high-risk patients is crucial for early diagnosis and intervention. Prompt urine screening and neuroimaging should be considered when gross lipiduria occurs after long bone fractures.

Chemiluminescence determination of surfactant Triton X-100 in environmental water with luminol-hydrogen peroxide system.

BACKGROUND: The rapid, simple determination of surfactants in environmental samples is essential because of the extensive use and its potential as contaminants. We describe a simple, rapid chemiluminescence method for the direct determination of the non-ionic surfactant Triton X-100 (polyethylene glycol tert-octylphenyl ether) in environmental water samples. The optimized experimental conditions were selected, and the mechanism of the Luminol-H2O2-Triton X-100 chemiluminesence system was also studied. RESULTS: The novel chemiluminescence method for the determination of non-ionic surfactant Triton X-100 was based on the phenomenon that Triton X-100 greatly enhanced the CL signal of the luminol-H2O2 system. The alkaline medium of luminol and the pH value obviously affected the results. Luminol concentration and hydrogen peroxide concentration also affected the results. The optimal conditions were: Na2CO3 being the medium, pH value 12.5, luminol concentration 1.0 x 10(-4) mol L(-1), H2O2 concentration 0.4 mol L(-1). The possible mechanism was studied and proposed. CONCLUSION: Under the optimal conditions, the standard curve was drawn up and quotas were evaluated. The linear range was 2 x 10(-4) g mL(-1)-4 x 10(-2) g mL(-1) (w/v), and the detection limit was 3.97 x 10-5 g mL(-1) Triton X-100 (w/v). The relative standard deviation was less than 4.73% for 2 x 10(-2) g mL(-1) (w/v) Triton X-100 (n = 7). This method has been applied to the determination of Triton X-100 in environmental water samples. The desirable recovery ratio was between 96%-102% and the relative standard deviation was 2.5%-3.3%. The luminescence mechanism was also discussed in detail based on the fluorescence spectrum and the kinetic curve, and demonstrated that Triton X-100-luminol-H2O2 was a rapid reaction.