The Pediatric Pain Screening Tool (PPST) can Rapidly Identify Elevated Pain and Psychosocial Symptomatology in Treatment-Seeking Youth with Acute Musculoskeletal Pain.

This cross-sectional study examines the utility of the Pediatric Pain Screening Tool (PPST) for rapidly assessing pain and psychosocial symptomatology in treatment-seeking youth with acute musculoskeletal pain. Participants were 166 youth (10-18 years, 53.6% female) participating in one of two larger cohort studies of youth with acute musculoskeletal pain. Youth completed the PPST and measures of pain, pain-related fear, pain catastrophizing, pain-related disability, and sleep quality. Participants were categorized into PPST risk groups using published cut-offs. ANOVA and chi-square examined associations between PPST risk groups and self-report measures; receiver operating characteristic (ROC) analyses examined associations among PPST scores and clinical reference cut-offs. The PPST classified 28.3% of youth as high, 23.5% as moderate, and 48.2% as low-risk. Females were more likely to be high-risk. ANOVAs revealed differences in clinical factors by PPST risk group particularly differences among youth labeled high versus low-risk. ROC analyses showed the PPST is effective in discriminating "cases" versus "non-cases" on pain-related disability, pain-fear and catastrophizing. Results reveal the PPST is effective for rapidly screening youth with acute pain for pain and psychosocial symptomatology. An important next step will be to examine the validity of the PPST in predicting recovery outcomes of acute pain samples. PERSPECTIVE: This article presents the Pediatric Pain Screening Tool (PPST) as a measure for rapidly screening youth with acute pain for pain and psychosocial symptomatology. The tool categorizes youth into low, moderate or high-risk groups and discriminates among those with versus without clinically significant levels of disability, pain-related fear and catastrophizing.

Prevalence of Osteochondral Lesions in Rotational Type Ankle Fractures With Syndesmotic Injury.

BACKGROUND:: The aim of this study was to report the incidence of associated osteochondral lesions (OCLs) on postop CTs, which may benefit from arthroscopic treatment, in patients with rotational type ankle fractures with syndesmotic injury. The diagnosis and treatment of associated OCLs may be an additional benefit of the use of arthroscopy in the management of rotational type ankle fractures with syndesmotic injury. METHODS:: We retrospectively reviewed data of a prospective cohort study of patients who underwent open reduction and surgical fixation of an ankle fracture with syndesmotic injury. These patients underwent routine bilateral postoperative CT assessment. Two independent observers classified ankle fractures according to Weber and OCLs according to the classification system by Berndt and Harty. Fifty-nine patients were included. There were 19 (32%) Weber B type ankle fractures and 39 (66%) Weber C type fractures. One patient (2%) had fixation for a medial malleolus fracture and syndesmotic rupture without fibula fracture. RESULTS:: Talar OCLs were present in 8 patients (14%). In one patient, 2 OCLs were found, which resulted in a total of 9 lesions. Two lesions were found on the medial side, both anterior. The other 7 were located laterally, of which 1 was anterior, 3 central, and 3 posterior on the talus. According to the Berndt and Harty classification, 1 was classified as stage I, 4 as stage III, and 4 as stage IV. CONCLUSION:: The prevalence of OCLs in ankle fractures with syndesmotic instability was 14%. We believe that lesions were arthroscopically accessible in 6 patients (10%). Moreover, most lesions were located on the lateral dome, and thus also potentially approachable through an anterolateral arthrotomy during open reduction and internal fixation. The majority of OCLs found in this series were Berndt and Harty type III or IV, and so likely would preferably have been addressed during the index procedure. LEVEL OF EVIDENCE:: Level III, diagnostic cohort study.

The synthesis of novel chromogenic enzyme substrates for detection of bacterial glycosidases and their applications in diagnostic microbiology.

The preparation and evaluation of chromogenic substrates for detecting bacterial glycosidase enzymes is reported. These substrates are monoglycoside derivatives of the metal chelators catechol, 2,3-dihydroxynaphthalene (DHN) and 6,7-dibromo-2,3-dihydroxynaphthalene (6,7-dibromo-DHN). When hydrolysed by appropriate bacterial enzymes these substrates produced coloured chelates in the presence of ammonium iron(III) citrate, thus enabling bacterial detection. A ß-d-riboside of DHN and a ß-d-glucuronide derivative of 6,7-dibromo-DHN were particularly effective for the detection of S. aureus and E. coli respectively.