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The purpose of this study was to evaluate the relationship between economic activity and the incidence of high-energy orthopedic trauma. California's Office of Statewide Health Planning and Development patient discharge database was queried to identify monthly orthopedic trauma incidence from 1995 to 2010. Patient inclusion required 1 diagnosis code and 1 associated procedural code for fractures of the femur, tibia, ankle, pelvis, or acetabulum. Data on composite market indices, energy and transportation use, and unemployment were obtained from government sources. Statistical analysis was performed using univariate and multivariate linear regression. The average monthly incidence of orthopedic trauma was 2.92 cases per 100,000 people. Of 15 economic indicators analyzed with univariate regression, 7 variables correlated with trauma incidence to statistical significance. Dow Jones Industrial Average (P=.032), Standard & Poor's 500 (P=.034), vehicle miles driven (P<.001), personal disposable income (P=.033), Coincident Economic Activity Index for California (P=.007), and vehicles purchased (P<.001) were positively correlated with trauma incidence. Unemployment (P<.001) was inversely correlated with trauma incidence. Multivariate regression was used to compute a combination of independent predictors of trauma volume: personal disposable income (P<.001), vehicles purchased (P=.008), and unemployment (P=.005). This combination of variables was used to develop the Crush Index to model the relationship between economic activity and orthopedic trauma volume. The authors show a positive correlation between economic strength and activity and the monthly volume of high-energy orthopedic trauma. The Crush Index serves as a proof of concept that may be useful in guiding preparedness among practitioners and health care system administrators. [Orthopedics. 2017; 40(4):248-255.].

Introduction:Oxazolidinone like linezolid are widely used antibiotics because of the growing prevalence of resistant gram-positive infections. Because of its unique mode of action by inhibiting protein synthesis, it is widely effective against various resistant strains like penicillin-resistant and vancomycin-resistant strains of various gram-positive bacteria. It is widely used in the treatment of skin and soft tissue infection including MRSA and MSSA, also used in community-acquired pneumonia, and the combination is used in extensively drug-resistant tuberculosis. The most common side effect of linezolid includes gastrointestinal disturbances like nausea and vomiting. Serious adverse effects include Myelosuppression including thrombocytopenia, anemia, pancytopenia, and leukopenia. Peripheral neuropathy, optic neuritis, and lactic acidosis are also reported. Case Presentation: Here we report a case of progressive but reversible thrombocytopenia in 75 years old male patient after receiving linezolid therapy for severe sepsis with multiorgan dysfunction with AKI on CKD with hepatic encephalopathy, severe hyponatremia with aspiration pneumonia. On the 9 th day of linezolid, therapy thrombocytopenia was noted and immediately linezolid was stopped. After the 12 th day, his platelet count went up which might be suggestive of linezolid induced thrombocytopenia. Conclusion: Physicians should be more vigilant in monitoring complete blood count, especially in elderly patients who are receiving linezolid for more than two weeks. They should also make a risk assessment based on creatinine clearance, baseline platelet count, immunosuppression therapy, baseline hemoglobin, and prior/present antibiotics therapy so that adverse reactions can be prevented.