An Overview of Pediatric Knee Arthroscopy With Use of the NeedleScope.

As sports-related injuries are becoming more common among children, there has been an increased need for knee arthroscopies in the pediatric population. Nevertheless, pediatric knee arthroscopy exposure is varied among orthopaedic surgeons, especially during residency training. There is a considerable difference in knee arthroscopy case volume between the adult and the pediatric population among orthopaedic residents. Although the fundamentals of adult knee arthroscopy have been well delineated, there is a paucity of literature surrounding basic pediatric knee arthroscopy. Our goal is to further explain the fundamentals needed to perform successful arthroscopic surgery in the pediatric knee. Through discussing proper patient positioning, instrumentation, including the utility of the 1.9-mm small-bore needle arthroscope (NanoScope; Arthrex, Naples, FL), subtle tips and tricks, as well as advantages and disadvantages of arthroscopy in children, this Technical Note along with the corresponding video are designed to help elucidate the intricacies of the pediatric knee. It will serve as educational material targeted to the resident trainee or any orthopaedic practitioner interested in gaining an introductory foundation to pediatric knee arthroscopy.

Efficacy of DIY Cast Covers: An In Vivo Study.

BACKGROUND: Casting is routinely used in orthopaedics. Preventing a wet cast is crucial for maintaining structural integrity and reducing unwanted complications like unnecessary skin irritation/ulceration, bacterial overgrowth, and unnecessary emergency department visits. Using experimental models, studies have tested various contemporary methods to prevent a wet cast. One such study found that in comparison the most effective and cost-conscious approach was to use a Do-It-Yourself cast cover using a double-bag technique sealed with tape. There is a paucity of literature on the utility of this technique in vivo. The purpose of this study was to investigate the efficacy of the Do-It-Yourself cast cover on human test subjects. METHODS: Ten volunteers for the study were obtained. Each received one short arm cast and one short leg cast. Each cast was removed after they were deemed dry. These casts were subsequently weighed until they achieved a stable weight. Each cast was then reapplied to the subject's arm and held together with Scotch tape. A trash bag was then applied around the cast and then secured with Duct tape to the skin. This was repeated to create a double seal. These covered, reapplied casts were submerged under water for 2 minutes. After submersion, the cover was removed, and the cast was reweighed. The casts were then submerged completely without any protection for 2 minutes and their fully saturated weight was recorded. Efficacy was determined by comparing the postsubmersion and full-submersion weights. Data was analyzed using the Mann-Whitney test. RESULTS: The percentage of water absorption prevention ranged from 96.8% to 99.9%, with an average of 99.6% across the entire study sample ( P <0.0001). No adverse effects were reported. CONCLUSION: Our findings conclude that the double-bag with Duct-tape method is effective at preventing external water absorption. This in vivo study demonstrates that almost all external water absorption can be prevented using this simple and inexpensive technique. LEVEL OF EVIDENCE: Level II, prospective comparative study.

The Perioperative Surgical Home in Pediatrics: Improve Patient Outcomes, Decrease Cancellations, Improve HealthCare Spending and Allocation of Resources during the COVID-19 Pandemic.

Cancellations or delays in surgical care for pediatric patients that present to the operating room create a great obstacle for both the physician and the patient. Perioperative outpatient management begins prior to the patient entering the hospital for the day of surgery, and many organizations practice using the perioperative surgical home (PSH), incorporating enhanced recovery concepts. This paper describes changes in standard operating procedures caused by the COVID-19 pandemic, and proposes the expansion of PSH, as a means of improving perioperative quality of care in pediatric populations.

Stereospecific modulation of dimeric rhodopsin.

The classic concept that GPCRs function as monomers has been challenged by the emerging evidence of GPCR dimerization and oligomerization. Rhodopsin (Rh) is the only GPCR whose native oligomeric arrangement was revealed by atomic force microscopy demonstrating that Rh exists as a dimer. However, the role of Rh dimerization in retinal physiology is currently unknown. In this study, we identified econazole and sulconazole, two small molecules that disrupt Rh dimer contacts, by implementing a cell-based high-throughput screening assay. Racemic mixtures of identified lead compounds were separated and tested for their stereospecific binding to Rh using UV-visible spectroscopy and intrinsic fluorescence of tryptophan (Trp) 265 after illumination. By following the changes in UV-visible spectra and Trp265 fluorescence in vitro, we found that binding of R-econazole modulates the formation of Meta III and quenches the intrinsic fluorescence of Trp265. In addition, electrophysiological ex vivo recording revealed that R-econazole slows photoresponse kinetics, whereas S-econazole decreased the sensitivity of rods without effecting the kinetics. Thus, this study contributes new methodology to identify compounds that disrupt the dimerization of GPCRs in general and validates the first active compounds that disrupt the Rh dimer specifically.-Getter, T., Gulati, S., Zimmerman, R., Chen, Y., Vinberg, F., Palczewski, K. Stereospecific modulation of dimeric rhodopsin.