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1.
J Pediatr Orthop ; 2024 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-39185569

RESUMO

BACKGROUND: The most frequent sequelae of pediatric lateral condyle fractures is lateral condyle overgrowth (LCO). The purpose of our study was to investigate LCO in relation to age, quality of reduction, type of fixation, and fracture displacement. METHODS: We retrospectively analyzed operatively treated lateral condyle fractures in children. The percent change in interepicondylar width (IEW) ((final - initial)/ initial x 100) was used to quantify LCO. IEW was measured from the medial and lateral epicondyles of the distal humerus, using the AP radiographs taken at admission (initial) and follow-up visits (final). The Song classification was used to classify fractures. Fixation was classified as pins, screws or both. The quality of reduction was defined as anatomic or nonanatomic (>2 mm of displacement). Patients were stratified into mild (0% to 10% overgrowth), moderate (10% to 20% overgrowth), and severe (>20% overgrowth) subgroups for further analysis. RESULTS: Two hundred one patients were included in the study with an average time between initial and final radiograph measurements of 11.32 weeks. There was an average 11.84 %LCO. Using multivariable analysis, three variables demonstrated significant, independent associations with %LCO: age, race, and quality of reduction. Increasing age remained inversely associated with %LCO. Compared with White patients, Black and Asian patients had significantly greater %LCO. Patients with nonanatomic reductions had a significantly greater %LCO compared with anatomic reductions. When patients were stratified into mild, moderate, and severe groups, age in the mild group, nonanatomic reduction in the moderate group, and race in the severe group were found to be independently associated with increased %LCO using multivariable analysis. CONCLUSIONS: The amount of LCO was found to be related to nonanatomic reduction, younger age, and Black and Asian race. Interestingly, it was not related to the amount of initial displacement or type of hardware used. To date, this is the largest study investigating LCO in surgically treated lateral condyle fractures. LEVEL OF EVIDENCE: Level III-retrospective cohort study.

2.
J Pediatr Orthop ; 44(6): e530-e535, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38512220

RESUMO

OBJECTIVE: Supracondylar humerus (SCH) fractures are common among pediatric patients, with the severity categorized using the Gartland classification system. Type 1 SCH fractures are nondisplaced and treated with immobilization, while more displaced fractures require surgery. The need for follow-up radiographs, particularly for type 1 fractures, is an area where evidence is lacking. This study investigates the clinical value and financial implications of follow-up radiographs for type 1 SCH fractures, hypothesizing that they do not alter clinical management and, therefore, represent an unnecessary expense. METHODS: This retrospective cohort study, approved by the Institutional Review Board, focused on patients under 18 with nondisplaced SCH fractures treated nonoperatively. One hundred one type 1 SCH fractures, in which the fracture was visible on presenting radiographs, were chosen from patients presenting between January 2021 and December 2022. Charts were reviewed for demographic information, time of cast removal, and complications. A pediatric orthopaedic surgeon and orthopaedic resident reviewed the radiographs to confirm the injury to be a type 1 SCH fracture. RESULTS: Among the 101 patients, after the initial presentation, 79 attended an interim visit and 101 attended a "3-week follow-up" at an average of 23 days postinjury. All patients underwent radiographs during these visits for a total of 180 radiographs after confirmation of type 1 SCH fracture. No changes in management resulted from follow-up radiographs. One instance of refracture was noted ~3 months after cast removal. There were 180 superfluous follow-up radiographs taken at subsequent clinic visits. The total charge for these radiographs was $76,001.40, averaging $752.49 per patient. CONCLUSION: Follow-up radiographs for type 1 SCH fractures did not lead to changes in clinical management, aligning with previous findings in more severe SCH fractures. This approach can reduce costs, radiation exposure, and clinic time without compromising patient care. The study can reassure providers and parents about the lack of necessity for follow-up radiographs to document healing. LEVEL OF EVIDENCE: Level-IV.


Assuntos
Fraturas do Úmero , Radiografia , Humanos , Estudos Retrospectivos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/terapia , Masculino , Feminino , Radiografia/métodos , Radiografia/estatística & dados numéricos , Criança , Pré-Escolar , Seguimentos , Lactente , Adolescente
3.
Biol Lett ; 16(7): 20200242, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32673546

RESUMO

Adaptive coloration among animals is one of the most recognizable outcomes of natural selection. Here, we investigate evolutionary drivers of white coloration in velvet ants (Hymenoptera: Mutillidae), which has previously been considered camouflage with the fruit of creosote bush (Larrea tridentata). Our analyses indicate instead that velvet ants evolved white coloration millions of years before creosote bush was widespread in North America's hot deserts. Furthermore, velvet ants and the creosote fruit exhibit different spectral reflectance patterns, which appear distinct to potential insectivorous predators. While the white coloration in velvet ants likely did not evolve as camouflage, we find that white-coloured species remain cooler than their red/orange relatives, and therefore we infer the white coloration likely evolved in response to Neogene desertification. This study shows the importance of cross-disciplinary investigation and of testing multiple hypotheses when investigating evolutionary drivers of adaptive coloration.


Assuntos
Formigas , Mimetismo Biológico , Animais , Ecologia , América do Norte
4.
Opt Express ; 27(19): 26281-26294, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31674513

RESUMO

We investigate the effect of a ring resonator on the linewidth and output spectrum of monolithically integrated extended cavity multi-section DBR lasers with an intra-cavity ring resonator. The goal is to achieve an understanding of whether and how the use of an additional ring filter improves the performance of a DBR laser on the aspects of the SMSR and intrinsic linewidth using the capabilities of the InP active-passive integration platform. The laser output spectrum is in good agreement with our theoretical calculations from a steady-state spectral model. A side-mode suppression ratio between 60 and 70 dB is measured for a range of operating semiconductor optical amplifier currents. The frequency noise power spectral density is measured for a range of output power levels. A minimum intrinsic linewidth of 63 kHz is reported. We compare the measured Lorentzian linewidths with our theoretical expectations and present estimates of the possible linewidth improvement with the available photonic integration technology used in this work.

5.
Opt Express ; 22(1): 435-42, 2014 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-24515003

RESUMO

We demonstrate for the first time WDM multi-path routing through a monolithically integrated InP/InGaAsP 8 × 8 space and wavelength selective cross-connect. Data channels are dynamically routed from four input ports to the same output port with excellent OSNR from 27.0 to 31.1 dB. Representative data paths are evaluated in terms of optical power penalty. Data routing experiments are performed using round-robin scheduling with nanosecond time-scale switching times.

6.
Zootaxa ; 5301(1): 105-123, 2023 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-37518570

RESUMO

This paper provides miscellaneous taxonomic updates for diurnal velvet ants in the USA. Six valid species of Dasymutilla Ashmead, 1899, one valid species of Ephuta Say, 1836 and six valid species of Pseudomethoca Ashmead, 1896 are regarded. Two new species are described: Pseudomethoca peremptrix sp. nov. and P. sonorae sp. nov. The female formerly associated with Dasymutilla zelaya (Blake, 1871) is recognized as a color variant of D. vestita (Lepeletier, 1845). Sixteen new synonymies are proposed: Dasymutilla chisos Mickel, 1928, syn. nov. under D. gloriosa (Saussure, 1868); D. cotulla Mickel, 1928, syn. nov., D. homole Mickel, 1928, syn. nov. and D. vandala Mickel, 1928, syn. nov. under D. vestita (Lepeletier, 1845); D. dorippa Mickel, 1928, syn. nov. under D. flammifera Mickel, 1928; D. ocydrome Mickel, 1928, syn. nov. under D. connectens (Cameron, 1895); Mutilla phaon Fox, 1899, syn. nov. under D. pseudopappus (Cockerell, 1895); M. zelaya Blake, 1871, syn. nov. under D. gorgon (Blake, 1871); Ephuta tentativa Schuster, 1951, syn. nov. under E. scrupea Say, 1836; P. dentifrontalis Bradley in Mickel, 1924, syn. nov. under P. athamas (Fox, 1899); P. albicoma Mickel, 1924, syn. nov., P. contumeliosa Mickel, 1935, syn. nov., P. manca Mickel, 1924, syn. nov. and P. oculissima Mickel, 1924, syn. nov. under P. contumax (Cresson, 1865); M. aeetis Fox, 1899, syn. nov. under P. sanbornii (Blake, 1871); and P. (Nomiaephagus) vanduzei Bradley, 1916, syn. nov. under P. wickhami (Cockerell & Casad, 1895).


Assuntos
Formigas , Himenópteros , Odonatos , Feminino , Estados Unidos , Animais
7.
Zootaxa ; 5231(2): 101-140, 2023 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-37045157

RESUMO

Twenty-six genera and five subgenera of the tribe Smicromyrmini are reviewed. The tribe (528 valid species) is Afrotropical (15 genera /126 species), Palaearctic (13/213) and Oriental (14/204) in distribution. The females are known for 80%, and males for 87%, of the 26 genera and five subgenera. The hitherto unknown female of Rasnitsynitilla Lelej in Lelej & van Harten, 2006 is described. New combinations are proposed for Rasnitsynitilla bartolozzii (Lo Cascio et Grita, 2014), comb. nov. (from the genus Smicromyrme Thomson, 1870) and Skorikovia sanguinicollis (Klug, 1829), comb. nov. (from the genus Ephutomma Ashmead, 1899). The genus Indratilla Lelej, 1993 is newly recorded from India and the subgenus Eremotilla Lelej, 1985 from the Oriental Region. Keys to females and males of these genera and subgenera of Smicromyrmini are provided. Habitus photos of males and/or females are provided for each genus and subgenus.


Assuntos
Himenópteros , Masculino , Feminino , Animais
8.
J Orthop Case Rep ; 13(6): 110-114, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37398517

RESUMO

Introduction: Bilateral femoral diaphyseal fractures in children due to nonaccidental trauma (NAT) are a rare occurrence, with no reported cases currently published in the literature. The authors present a case of an 8-month-old male who presented with bilateral femoral shaft fractures. History, physical examination, and radiographic findings support NAT as the cause of his injuries. Due to the patient's size and associated comorbidities, he was initially treated with Pavlik harness placement, rather than spica casting. The patient demonstrated appropriate radiographic evidence of fracture healing on follow-up. Case Report: An 8-month-old male with a complex past medical history presents to the emergency department. Per the patient's mother, he has been demonstrating a progressive loss of movement and refusal to bear weight in his bilateral lower extremities over the preceding 1-2 weeks. Other injuries include facial bruising and lesions indicative of subconjunctival hemorrhages. After orthopedics was consulted, the decision was made to treat the patient's bilateral femoral shaft fractures with a Pavlik harness, rather than spica casting, due to his small size and associated past medical history. The patient was subsequently discharged under foster care. Follow-up visit demonstrates appropriate fracture healing in the bilateral femoral diaphyses. Conclusion: Many cases of NAT in the pediatric population are initially missed. Orthopedic providers must maintain a high index of suspicion for NAT as many of these patients will present with musculoskeletal injuries. The authors report a rare case of NAT in a male child resulting in bilateral femoral diaphyseal fractures. The patient was successfully treated through Pavlik harness placement. Orthopedic providers should consider Pavlik harness placement as a viable option even for young children >6 months of age presenting with femoral shaft fractures if spica casting or open reduction internal fixation is not appropriate.

9.
Case Rep Orthop ; 2023: 4104127, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38090676

RESUMO

Introduction: Proximal tibia physeal fractures in children are not very common but can be dangerous because they can harm popliteal fossa structures, especially the popliteal artery. Popliteal artery injuries (PAI) are most commonly the result of trauma to the lower extremity, including blunt force, hyperextension injuries, complex fractures, and knee dislocations that can compromise popliteal neurovascular structures. Case Presentation. A 14-year-old boy presents to the emergency department after being transferred from an outside hospital 24 hours after a left lower extremity hyperextension injury. Radiographs demonstrated a Salter-Harris III proximal tibia fracture with posterior displacement. ABIs were deferred due to palpable distal pulses and no evidence of compartment syndrome. Closed reduction and percutaneous pinning were planned to correct the fracture. Intraoperatively, it was discovered that knee extension decreased lower extremity perfusion while knee flexion returned perfusion. An angiography revealed a popliteal artery occlusion with no distal flow. Based on this, an above-knee to below-knee popliteal bypass using the contralateral great saphenous vein was performed followed by closed reduction and percutaneous pinning of the proximal tibia. Conclusion: Proximal tibia physeal injuries, especially the Salter-Harris III and IV injuries, warrant a high index of suspicion of popliteal artery injuries. Palpable pulses and delayed presentation in the distal lower extremity do not rule out a PAI because collateral flow to the anterior and posterior tibial arteries may mask signs of an avascular limb, highlighting the need for a thorough history and physical exam. The authors present this case to reaffirm the importance of an ankle-brachial index when evaluating hyperextension injuries with proximal tibial epiphyseal fractures.

10.
Injury ; 54(2): 552-556, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36522213

RESUMO

BACKGROUND: Recent studies suggest pediatric Gustilo-Anderson type I fractures, especially of the upper extremity, may be adequately treated without formal operative debridement, though few tibial fractures have been included in these studies. The purpose of this study is to provide initial data suggesting whether Gustilo-Anderson type I tibia fractures may be safely treated nonoperatively. METHODS: Institutional retrospective review was performed for children with type I tibial fractures managed with and without operative debridement from 1999 through 2020. Incomplete follow-up, polytrauma, and delayed diagnosis of greater than 12 h since the time of injury were criteria for exclusion. Data including age, sex, mechanism of injury, management, time-to-antibiotic administration, and complications were recorded. RESULTS: Thirty-three patients met inclusion criteria and were followed to union. Average age was 9.9 ± 3.7 years. All patients were evaluated in the emergency department and received intravenous antibiotics within 8 h of presentation. Median time-to-antibiotics was 2 h. All patients received cefazolin except one who received clindamycin at an outside hospital and subsequent cephalexin. Three patients (8.8%) received augmentation with gentamicin. Twenty-one patients (63.6%) underwent operative irrigation and debridement (I&D), and of those, sixteen underwent surgical fixation of their fracture. Twelve (36.4%) patients had bedside I&D with saline under conscious sedation, with one requiring subsequent operative I&D and intramedullary nailing. Three infections (14.3%) occurred in the operative group and none in the nonoperative group. Complications among the nonoperative patients include delayed union (8.3%), angulation (8.3%), and refracture (8.3%). Complications among the operative patients include delayed union (9.5%), angulation (14.3%), and one patient experienced both (4.8%). Other operative group complications include leg-length discrepancy (4.8%), heterotopic ossification (4.8%), and symptomatic hardware (4.8%). CONCLUSION: No infections were observed in a small group of children with type I tibia fractures treated with bedside debridement and antibiotics, and similar non-infectious complication rates were observed relative to operative debridement. This study provides initial data that suggests nonoperative management of type I tibial fractures may be safe and supports the development of larger studies.


Assuntos
Fixação Intramedular de Fraturas , Fraturas Expostas , Fraturas da Tíbia , Humanos , Criança , Adolescente , Tíbia , Fraturas da Tíbia/complicações , Fraturas da Tíbia/cirurgia , Cefazolina , Antibacterianos/uso terapêutico , Estudos Retrospectivos , Fraturas Expostas/complicações , Fraturas Expostas/cirurgia , Resultado do Tratamento
11.
Foot Ankle Orthop ; 8(1): 24730114231164146, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37009419

RESUMO

Background: The peroneus longus (PL) and peroneus brevis (PB) tendons comprise the lateral compartment of the leg and stabilize the foot during weightbearing. Peroneal tendinopathy can precipitate lateral ankle pain and induce functional disability. The progression of peroneal pathology to lateral ankle dysfunction is thought to stem from asymptomatic, subclinical peroneal tendinopathy. There may be clinical benefit to identifying asymptomatic patients with this condition before progression to disability. Various ultrasonographic characteristics have been observed in peroneal tendinopathy. The purpose of this study is to identify the frequency of subclinical tendinopathic characteristics in asymptomatic peroneal tendons. Methods: One hundred seventy participants underwent bilateral foot and ankle ultrasonographic examination. Images were assessed for abnormalities of the PL and PB tendons by a group of physicians who recorded frequencies of abnormalities. This team consisted of an orthopaedic surgeon specializing in foot and ankle surgery, a fifth-year orthopaedic surgery resident, and a family medicine physician with musculoskeletal sonographer certification. Results: A total of 340 PL and 340 PB tendons were assessed. Sixty-eight (20%) PL and 41 (12.1%) PB tendons had abnormal traits. Twenty-four PLs and 22 PBs had circumferential fluid, 16 PLs and 9 PBs had noncircumferential fluid, 27 PLs and 6 PBs had thickening, 36 PLs and 12 PBs had heterogenicity, 10 PLs and 2 PBs had hyperemia, and 1 PL had calcification. In Caucasian participants, male gender was associated with increased frequency of abnormal findings, but there were no other significant differences based on age, body mass index, or ethnicity. Conclusion: In our studied population of 170 patients who had no complaints of associated symptoms, we found that 20% of PLs and 12% of PBs displayed ultrasonographic abnormalities. When we included all unusual findings within and around the tendons, prevalence rates of ultrasonographic abnormalities were 34% for PLs and 22% for PBs. Level of Evidence: Level II, prospective cohort study.

12.
Zootaxa ; 5228(4): 455-476, 2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-37044643

RESUMO

The species in the tribe Mutillini (Mutillidae: Mutillinae) sensu Waldren et al. (2022, in press) of the Oriental region are reviewed. Fourteen species in the genera Kurzenkotilla Lelej, 2005, Mutilla Linnaeus, 1758, Standfussidia Lelej, 2005, and Storozhenkotilla Lelej, 2005 are keyed, reviewed, and illustrated. The males of the genus Kurzenkotilla are described and associated with the females. One new species: Storozhenkotilla nathani Lelej, sp. nov., male is described from India (Karnataka and Kerala). New combinations are proposed for Kurzenkotilla harmandi (André, 1898), comb. nov., K. rufodorsata (Cameron, 1897), comb. nov., K. semiviolacea (André, 1896), comb. nov., K. cicatricifera (André, 1894), comb. nov., and Storozhenkotilla binghami (Lelej, 2005), comb. nov. Six new country records are presented: Kurzenkotilla niveosignata (André, 1894) from Pakistan, K. annamensis Lelej, 2005 from Thailand, K. visrara (Cameron, 1898) from India, K. scrobiculata (Hammer, 1962) from Nepal, K. rufodorsata (Cameron, 1897) from Nepal, and Storozhenkotilla binghami Lelej, 2005 from Sri Lanka. Specimens of Mutilla mikado Cameron, 1900 from China were misidentified as Mutilla europaea by Su et al. (2019), and we recognize M. mikado as the sole member of the genus Mutilla to occur in the Oriental region. A key to the species of Oriental Mutillini is provided.


Assuntos
Besouros , Himenópteros , Feminino , Masculino , Animais , Índia
13.
Neotrop Entomol ; 51(3): 427-446, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35474570

RESUMO

Most holotype specimens of Horcomutilla and other non-type materials deposited in museums of the Americas and Europe were examined resulting in the recognition of 13 valid species in Horcomutilla occurring from Panama to southern Argentina. Six species are known from both sexes, six only from females and one only from the male. The new species Horcomutilla bernali Cambra & Williams, sp. nov., female and male, and Horcomutilla igriega Cambra & Williams, sp. nov., male, are described. The previously unknown males of H. denticeps (Spinola Spinola, Famille Mutillaires Latr Mem Acad Sci Turin 13:62-63, 1853) and H. piala Casal Casal, Physis 30:171-172, 1970, are recognized and described. Horcomutilla suis Casal Casal, Notas Mus La Plata, Zool 20:63-75, 1962 is recognized as a junior synonym of Horcomutilla denticeps (Spinola, Spinola, Famille Mutillaires Latr Mem Acad Sci Turin 13:62-63, 1853). Horcomutilla projectifrons (Cresson, Cresson, Trans Amer Ent Soc 28:1-82, 1902) is recognized as a junior synonym of Horcomutilla fronticornis (Burmeister, Burmeister, Abhandl Naturf Ges Halle 2:19-29, 1854). Horcomutilla toba Casal, Casal, Notas Mus La Plata, Zool 20:63-75, 1962 is recognized as a junior synonym of H. glabriceps (André, André, Anales Mus Nac Buenos Aires 3:169-214, 1908). The genus Horcomutilla is reported for the first time from Colombia, Peru, Bolivia, Uruguay, and Trinidad. An updated key for species of the genus is presented and diagnostic morphological characters to separate all species are illustrated.


Assuntos
Himenópteros , Animais , Argentina , Bolívia , Colômbia , Feminino , Masculino , Panamá
14.
Zootaxa ; 5108(1): 1-97, 2022 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-35391392

RESUMO

The Traumatomutilla indica species-group is reviewed, leaving it with 13 species known from both sexes, four known from females only and two known from males only. The following 28 junior synonyms are proposed: Traumatomutilla aemulata (Cresson, 1902) [=Mutilla caneta Cresson, 1902, syn. nov.]; T. centralis (Burmeister, 1875) [=T. fissiventris Andr, 1907, syn. nov.; =T. centralis boliviana Casal, 1969, syn. nov.]; T. contempta Andr, 1908a [=T. alhuampa Casal, 1969, syn. nov.]; T. geographica (Gerstaecker, 1874) [=T. seabrai Casal, 1969, syn. nov.]; T grossa (Gerstaecker, 1874) [=Mutilla abrupta Gerstaecker, 1874, syn. nov.; =M. characterea Gerstaecker, 1874, syn. nov.]; T. guayaca Casal, 1969 [=T. tayguaya Casal, 1969 syn. nov.]; T. indica (Linnaeus, 1758) [=M. sphegea Fabricius, 1804, syn. nov.]; T. parallela (Klug, 1821) [=M. almada Cresson, 1902, syn. nov.; =Ephuta lineifera Andr, 1903, syn. nov.; =T. indicoides Mickel, 1952, syn. nov.; =T. gausapata Mickel, 1952, syn. nov.; =T. pillinata Casal, 1969, syn. nov.]; T. puella (Gerstaecker, 1874) [=M. musculus Gerstaecker, 1874, syn. nov.; =M. manca Cresson, 1902 syn. nov.; =M. viana Cresson, 1902, syn. nov.; =T. peperina Casal, 1969, syn. nov.]; T. spectabilis (Gerstaecker, 1874) [=M. funesta Gerstaecker, 1874, syn. nov.; =M. melaleuca Gerstaecker, 1874 syn. nov.; =T. spectabilis chingona Casal, 1969, syn. nov.]; T. tristis (Klug, 1821) [=M. foveiventris Gerstaecker, 1874, syn. nov.; =M. caxara Cresson, 1902, syn. nov.]; T. unimarginata (Cresson, 1902) [=M. cuiba Cresson, 1902, syn. nov.]; T. vidua (Klug, 1821) [=M. graphica Gerstaecker, 1874, syn. nov.; =M. scripta Gerstaecker, 1874, syn. nov.; =T. cachimba Casal, 1969, syn. nov.; =T. scripta borrosa Casal, 1969, syn. nov.]. The hitherto unknown males of T. guayaca Casal, 1969, T. ingens (Andr, 1903), and female of T. selligera (Gerstaecker, 1874) are described. A new combination is proposed for Traumatomutilla impetuosa (Smih, 1879), comb. nov. from Mutilla. All species treated are redescribed and illustrated. Identification keys for males and females are also provided.


Assuntos
Gastrópodes , Himenópteros , Melaleuca , Animais , Abelhas , Feminino , Masculino
15.
Artigo em Inglês | MEDLINE | ID: mdl-36166203

RESUMO

Sternoclavicular joint infections and osteomyelitis of the clavicle are extremely rare infections, especially in the pediatric population. Early signs of these infections are nonspecific and can be mistaken for common upper respiratory infections such as COVID-19 and influenza. Rapid diagnosis and treatment are critical for preventing potentially fatal complications such as mediastinitis. We present three cases of sternoclavicular joint infections in the past year during the COVID-19 pandemic. All three patients had delayed diagnoses likely secondary to COVID-19 workup. Each patient underwent surgical irrigation and débridement. Two of three patients required multiple surgeries and prolonged antibiotic courses. Placement of antibiotic-impregnated calcium sulfate beads into the surgical site cleared the infection in all cases where they were used. All three patients made a full recovery; however, the severity of their situations should not be overlooked. Children presenting to the hospital with chest pain, fever, and shortness of breath should not simply be discharged based on a negative COVID-19 test or other viral assays. A higher index of suspicion for bacterial infections such as clavicular osteomyelitis is important. Close attention must be placed on the physical examination to locate potential areas of concentrated pain, erythema, or swelling to prompt advanced imaging if necessary.


Assuntos
COVID-19 , Osteomielite , Articulação Esternoclavicular , Antibacterianos/uso terapêutico , Teste para COVID-19 , Sulfato de Cálcio , Criança , Clavícula/diagnóstico por imagem , Clavícula/microbiologia , Clavícula/cirurgia , Diagnóstico Tardio , Humanos , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Osteomielite/microbiologia , Pandemias , Articulação Esternoclavicular/diagnóstico por imagem , Articulação Esternoclavicular/microbiologia , Articulação Esternoclavicular/cirurgia
16.
J Child Orthop ; 16(6): 488-497, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36483642

RESUMO

Objectives: To evaluate the available literature for postoperative fracture rates following implant removal in the pediatric population. Methods: A systematic review of articles in the PubMed and Embase computerized literature databases from January 2000 to June 2022 was performed using PRISMA guidelines. Randomized controlled trials, case-control studies, cohort studies (retrospective and prospective), and case series involving pediatric patients that included data on fracture rate following removal of orthopedic implants were eligible for review. Two authors independently extracted data from selected studies for predefined data fields for implant type, anatomic location of the implant, indication for implantation, fracture or refracture rate following implant removal, mean time to implant removal, and mean follow-up time. Results: Fifteen studies were included for qualitative synthesis. Reported fracture rates following implant removal vary based on several factors, with an overall reported incidence of 0%-14.9%. The available literature did not offer sufficient data for conduction of a meta-analysis. Conclusion: Our systematic review demonstrates that fracture following implant removal in pediatric patients is a relatively frequent complication. In children, the forearm and femur are the most commonly reported sites of fracture following removal of implants. Traumatic fractures treated definitively with external fixation have the highest reported aggregate rate of refracture. Knowledge of the incidence of this risk is important for orthopedic surgeons. There remains a need for well-designed studies and trials to further clarify the roles of the variables that contribute to this complication.

17.
Opt Express ; 19(18): 17232-43, 2011 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-21935087

RESUMO

Phase-modulated ring resonant switches are receiving increasing attention for monolithic Silicon photonic networks. Resilience to fabrication variations and operational tolerances are however required to create networks with sufficient connectivity and bandwidth. In this work we use the combination of vectorial optical-mode propagation and transfer matrix calculation to map fabrication-level feature size variation to the optical switch performance metrics for extinction ratio, bandwidth and power penalty. Fabrication tolerances may be relaxed considerably through the combination of moderate size directional couplers of up to 30 µm, moderate 400 GHz free spectral range resonator design and the use of fifth order resonance. High speed 10 Gb/s, wavelength-multiplex-compliant, optical signal routing is predicted with on-state power penalties of 0.2 dB - 0.7 dB and off-state signal extinctions of - 62 dB.

18.
Opt Express ; 19(26): B531-6, 2011 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-22274066

RESUMO

We present an InP monolithically integrated wavelength selector that implements a binary search for selecting N modulated wavelengths. The wavelength selector filter is realized using log(2)N an active Mach-Zehnder interferometer filter and broadband optical gating elements. Nanosecond reconfigurable operation with a spectral-alignment over 3.2 nm free spectral range is achieved with an extinction ratio exceeding 25 dB. Error-free operation of the wavelength selector for four modulated wavelengths with 2 dB of power penalty is demonstrated.

19.
Opt Lett ; 36(19): 3846-8, 2011 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-21964117

RESUMO

We present an InP monolithically integrated wavelength selector that implements a binary search for selecting one from N modulated wavelengths. The InP chip requires only log(2)N optical filters and log(2)N optical switches. Experimental results show nanosecond reconfiguration and error-free wavelength selection of four modulated wavelengths with 2 dB of power penalty.

20.
Zootaxa ; 4920(1): zootaxa.4920.1.2, 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33756674

RESUMO

Ten species of Eotrogaspidia Lelej, 1996, two related species of Trogaspidia Ashmead, 1899 and one related species of Vanhartenidia Lelej in Lelej van Harten, 2006 are revised. Before this study, Eotrogaspidia included the following four species: E. amans (André, 1909) (♂♀), E. auroguttata (Smith, 1855) (♂♀), E. ekka (Nurse, 1902) (♀) and E. oryzae (Pagden, 1934) (♂♀). In the present paper, four new species are described: E. adhabar sp. nov. (♂) (India, Nepal), E. buddha sp. nov. (♂♀) (India, Nepal, Pakistan, Sri Lanka), E. hauseri sp. nov. (♂) (India, Nepal) and E. melanopleura sp. nov. (♀) (China). Three species are transferred to Eotrogaspidia from Trogaspidia: E. lena (Cameron, 1899), comb. nov. (♂), E. rubripes (André, 1901), comb. nov. (♀) and E. saussurei (Lelej, 2005), comb. nov. (♂♀). Mutilla ekka Nurse, 1902 from India is transferred from Eotrogaspidia to Vanhartenidia ekka, comb. nov. The male of E. saussurei is described. New synonymies are proposed for E. auroguttata (= T. vallicola Tsuneki, 1993, syn. nov.) and Trogaspidia mackieae (Cockerell, 1928) (= T. pacifica Tsuneki, 1972, syn. nov.). Eight new country records are presented: one from China, two from Laos, one from Vietnam, two from India, one from Iran, and one from Afghanistan. Female specimens of E. buddha sp. nov. were formerly misidentified as T. acidalia (Cameron, 1897), stat. resurr. by the late B. Petersen. The lectotype of T. acidalia is designated and illustrated to clarify its identity. Diagnoses and illustrations for reviewed species and a key to all known Eotrogaspidia species and related genera are provided for males and females.


Assuntos
Himenópteros , Animais , Feminino , Masculino
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