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An understanding of the clinical characteristics of children with coronavirus disease 2019 in diverse communities is needed to optimize the response of healthcare providers during this pandemic.

We performed a retrospective review of all children presenting to the Texas Children's Hospital system with testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from March 10, 2020 through June 28, 2020.Demographics were recorded for all patients undergoing testing and clinical characteristics and outcomes were recorded for children with positive tests.

Of 16,554 unique patients ≤ 21 years of age who were tested for SARS-CoV-2, 1215 (7.3%) patients tested positive. Isoxazole 9 solubility dmso Infants under 1 year of age and patients aged 18-21 years had the highest percent of positive tests at 9.9% (230/2329) and 10.7% (79/739), respectively. Hispanic children accounted for 66% (802/1215) of positive tests, though they only represented 42.1% (6972/16554) of all children tested for SARS-CoV-2. Of the 1215 children with a positive test, 55.7% had fever, 40.9% had cough, 39.8% had congestion or rhinorrhea, 21.9% had gastrointestinal complaints, and 15.9% were asymptomatic. Only 97 (8%) patients were hospitalized (of which 68% were Hispanic). Most hospitalized patients had underlying medical conditions (62/97, 63.9%), including obesity. Thirty-one hospitalized patients (31/97, 32%) required respiratory support and nine patients (9/97, 9.3%) received SARS-CoV-2 antiviral therapy. Two patients died.

A relatively high percentage of Hispanic children tested positive for SARS-CoV-2 and were hospitalized. Most children with detection of SARS-CoV-2 had uncomplicated illness courses, some children were critically ill, and two patients died.

A relatively high percentage of Hispanic children tested positive for SARS-CoV-2 and were hospitalized. Most children with detection of SARS-CoV-2 had uncomplicated illness courses, some children were critically ill, and two patients died.

This study describes the technique for decompression of the intermetatarsal nerve in Morton's neuroma by ultrasound-guided surgical resection of the transverse intermetatarsal ligament. This technique is based on the premise that Morton's neuroma is primarily a nerve entrapment disease. As with other ultrasound-guided procedures, we believe that this technique is less traumatic, allowing earlier return to normal activity, with less patient discomfort than with traditional surgical techniques.

We performed a pilot study on 20 cadavers to ensure that the technique was safe and effective. No neurovascular damage was observed in any of the specimens. In the second phase, ultrasound-guided release of the transverse intermetatarsal ligament was performed on 56 patients through one small (1- to 2-mm) portal using local anesthesia and outpatient surgery.

Of the 56 participants, 54 showed significant improvement and two did not improve, requiring further surgery (neurectomy). The postoperative wound was very small (1-2 mm). There were no cases of anesthesia of the interdigital space, and there were no infections.

The ultrasound-guided decompression of intermetatarsal nerve technique for Morton's neuroma by releasing the transverse intermetatarsal ligament is a safe, simple method with minimal morbidity, rapid recovery, and potential advantages over other surgical techniques. Surgical complications are minimal, but it is essential to establish a good indication because other biomechanical alterations to the foot can influence the functional outcome.

The ultrasound-guided decompression of intermetatarsal nerve technique for Morton's neuroma by releasing the transverse intermetatarsal ligament is a safe, simple method with minimal morbidity, rapid recovery, and potential advantages over other surgical techniques. Surgical complications are minimal, but it is essential to establish a good indication because other biomechanical alterations to the foot can influence the functional outcome.

We aimed to determine the center of pressure (COP) trajectories and regional pressure differences in natural rearfoot strikers while running barefoot, running with a minimalist shoe, and running with a traditional shoe.

Twenty-two male natural rearfoot strikers ran at an imposed speed along an instrumented runway in three conditions barefoot, with a traditional shoe, and with a minimalist shoe. Metrics associated to the COP and regional plantar force distribution, captured with a pressure platform, were compared using one-way repeated-measures analysis of variance.

The forefoot contact phase was found to be significantly shorter in the barefoot running trials compared with the shod conditions (P = .003). The initial contact of the COP was located more anteriorly in the barefoot running trials. The mediolateral position of the COP at initial contact was found to be significantly different in the three conditions, whereas the final mediolateral position of the COP during the forefoot contact phase was found to be more lateral in the barefoot condition compared with both shod conditions (P = .0001). The metrics associated with the regional plantar force distribution supported the clinical reasoning with respect to the COP findings.

The minimalist shoe seems to provide a compromise between barefoot running and running with a traditional shoe.

The minimalist shoe seems to provide a compromise between barefoot running and running with a traditional shoe.

We sought to highlight the humanistic aspect of hallux valgus.

We conducted a bibliographic search between 2013 and 2017 of scientific, historic, and humanistic articles, in search of the anthropological dimension of hallux valgus. Museums and works of art by relevant painters were analzyed for the presence of hallux valgus.

We showcase the linguistic origin of the terms related to hallux valgus, the evolution of its incidence depending on the footwear and social habits throughout history, the presence of hallux valgus in the work of great painters, and some other curiosities of this pathology.

The knowledge of the humanistic aspect of pathologies we treat, if not imperative for its proper surgical resolution, can help to improve the understanding of them.

The knowledge of the humanistic aspect of pathologies we treat, if not imperative for its proper surgical resolution, can help to improve the understanding of them.

We compared postoperative outcomes in adolescent patients who did and did not undergo plate-screw fixation of at least one of the lateral, medial, or posterior malleoli in ankle fractures. It was hypothesized that using plate-screw fixation would not negatively affect postoperative outcomes.

All of the preoperative data and postoperative outcomes for 56 patients with ankle fractures aged 12 to 15 years who underwent surgical treatment between January 1, 2007, and December 31, 2017, were reviewed retrospectively. Patients were grouped into plate-screw fixation (n = 15) and non-plate-screw fixation (n = 41) groups and as high- and low-energy trauma patients.

There were no significant differences in postoperative outcomes between the plate-screw fixation and non-plate-screw fixation groups. link2 The mean American Orthopaedic Foot & Ankle Society score of high-energy trauma patients was significantly lower than that of low-energy trauma patients (P < .001), and the rate of degenerative change in high-energy trauma patients was significantly higher than that in low-energy trauma patients (P = .008). There were no significant differences between high- and low-energy trauma patients with respect to other postoperative outcomes.

If anatomical reduction is performed without damaging the growth plate, postoperative clinical outcomes may be near perfect regardless of screw-plate fixation use. Postoperative outcomes of adolescent ankle fracture after high-energy trauma, independent of Salter-Harris classification and surgical treatment methods, were negative.

If anatomical reduction is performed without damaging the growth plate, postoperative clinical outcomes may be near perfect regardless of screw-plate fixation use. Postoperative outcomes of adolescent ankle fracture after high-energy trauma, independent of Salter-Harris classification and surgical treatment methods, were negative.

Diagnosis of onychomycosis using the periodic acid-Schiff (PAS) test for sensitive identification of hyphae and fungal culture for identification of species has become the mainstay for many clinical practices. With the advent of polymerase chain reaction (PCR) testing, physicians can identify a fungal toenail infection quickly with the added benefit of species identification. We compared PAS testing with multiplex PCR testing from a clinical perspective.

A total of 209 patients with clinically diagnosed onychomycosis were recruited. A high-resolution picture was taken of the affected hallux nail, and the nail was graded using the Onychomycosis Severity Index. A proximal sample of the affected toenail and subungual debris were obtained and split into two equal samples. One sample was sent for multiplex PCR testing and the other for PAS testing. The results were analyzed and compared.

Six patients were excluded due to insufficient sample size for PCR testing. Of the remaining 203 patients, 109 (53.7%) tested positive with PAS, 77 (37.9%) tested positive with PCR. Forty-one patients tested positive with PAS but negative with PCR, and nine tested positive with PCR but negative with PAS.

Physicians should continue the practice of using PAS biopsy staining for confirmation of a fungal toenail infection before using oral antifungal therapy. Because multiplex PCR allows species identification, some physicians may elect to perform both tests.

Physicians should continue the practice of using PAS biopsy staining for confirmation of a fungal toenail infection before using oral antifungal therapy. Because multiplex PCR allows species identification, some physicians may elect to perform both tests.Woringer-Kolopp disease is a rare variant of mycosis fungoides, a type of cutaneous T-cell lymphoma. Described is a case of a small annular plaque on the foot diagnosed histologically as Woringer-Kolopp disease and treated successfully with topical and intralesional steroids. In addition, a brief review of the literature and treatment options is provided.Schwannomas are benign, encapsulated soft-tissue tumors that rarely present to the foot and ankle. These tumors are usually asymptomatic unless an increase in size or disruption of the nerve causes pain. We report a case of a painful mass along the lateral plantar nerve near the fourth metatarsal base that was surgically excised and confirmed as a benign schwannoma by means of histopathologic analysis. At the final follow-up of over 2 years, the patient reported no pain, neurologic deficits, or signs of recurrence. This case demonstrates an unusual location of a schwannoma arising from the lateral plantar nerve.A rare case of painful snapping around the Achilles tendon without reported injury in a healthy 30-year-old male amateur runner is reported. link3 The plantaris tendon was firmly attached to the Achilles tendon by adhesions, and its movement was restricted and impaired. All adhesions were removed and the plantaris tendon was liberated during surgery, with an excellent outcome. This case showed that previously described removal of the snapping tendon is not necessary because liberation of the plantaris tendon restored function of both the plantaris and the Achilles tendons.