Gatesgilmore1784

fication of infants exposed to HSV at delivery, and a focus on equity in prevention efforts.

In response to the COVID-19 pandemic, Washington State's Stay Home, Stay Healthy (SHSH) order was implemented on March 24, 2020. We hypothesized that pandemic mitigation measures might reduce sexually transmitted infection (STI) screening and/or transmission.

We used King County, WA STI surveillance and sexual health clinic (SHC) data from January 1, 2019, to July 31, 2020. We calculated mean weekly case counts for gonorrhea, primary and secondary (P&S) syphilis, male urethral gonorrhea, and early latent (EL) syphilis for 3 periods in 2020 pre-SHSH (January 1-March 23), SHSH (March 24-June 5), and reopening (June 6-July 31). Primary and secondary syphilis and male urethral gonorrhea were used as proxies for sexual behavior, and EL syphilis was used as a proxy for STI screening. We compared SHC visits (2019 vs. 2020) and SHC gonorrhea treatment practices (across 2020 periods).

Compared with January to July 2019, from January to July 2020, reported cases of gonorrhea, male urethral gonorrhea, P&S syphilis, and EL syphilis decreased by 9%, 5%, 16%, and 22%, respectively. Mean weekly case counts of gonorrhea, male urethral gonorrhea, and EL syphilis decreased pre-SHSH to SHSH, but all returned to pre-SHSH levels during reopening. Sexual health clinic visits during SHSH were 55% lower in 2020 than in 2019. In the SHC during SHSH, ceftriaxone treatment of gonorrhea decreased, whereas cefixime/cefpodoxime treatment and gonorrhea treatment with no testing increased.

Decreases in reported STIs concurrent with COVID-19 SHSH may reflect a true decline in STI transmission. However, the larger decreases in asymptomatic infections indicate that much of the observed decrease was likely due to decreased screening.

Decreases in reported STIs concurrent with COVID-19 SHSH may reflect a true decline in STI transmission. However, the larger decreases in asymptomatic infections indicate that much of the observed decrease was likely due to decreased screening.

In resource-limited settings, acute respiratory infections continue to be the leading cause of death in young children. We conducted postmortem investigations in children <5 years hospitalized with a clinical diagnosis of respiratory disease at Kenya's largest referral hospital.

We collected respiratory and other tissues postmortem to examine pathologic processes using histology, molecular and immunohistochemistry assays. Nasopharyngeal, trachea, bronchi and lung specimens were tested using 21-target respiratory pathogen real-time reverse transcription polymerase chain reaction assays deployed on Taqman Array Cards. Expert panels reviewed all findings to determine causes of death and associated pathogens.

From 2014 to 2015, we investigated 64 pediatric deaths (median age 7 months). Pneumonia was determined as cause of death in 70% (42/52) of cases where death was associated with an infectious disease process. The main etiologies of pneumonia deaths were respiratory syncytial virus (RSV) (n = 7, 19%),ccination, and maintenance or improved uptake of existing vaccines can contribute to further reductions in childhood mortality.

Therapies against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its life-threatening respiratory infection coronavirus disease 2019 (COVID-19) have been evaluated, including COVID-19 convalescent plasma (CCP). Multiple large reports of CCP treatment in adults exist. Pediatric data on CCP safety and efficacy are limited.

Single-center prospective, open-label trial looking at safety, antibody kinetics and outcomes of CCP (10 mL/kg, max 1 unit) treatment for COVID-19 in hospitalized pediatric patients with moderate to severe disease or at high-risk for serious illness.

Thirteen patients were enrolled. No infusion-related adverse events occurred. No hematologic or metabolic adverse events were noted during hospitalization or at 3-weeks. Ten patients had clinical improvement by day 7 (WHO eight-category ordinal severity scale for COVID-19). Following CCP, anti-SARS-CoV-2 anti-nucleocapsid IgG increased significantly at 24 hours and high levels were sustained at 7- and 21-days. Transient Iggic or antiviral interventions may be added as supported by emerging data.

To compare the outcomes and complications of bone transport over a nail (BTON) with those of bone transport over a plate (BTOP) for segmental tibial bone defects.

Retrospective matched case-control study design.

A major metropolitan tertiary referral trauma center.

Thirty-six patients with segmental tibial bone defects of >4 cm.

Either BTON or BTOP was performed on 18 patients.

We compared the healing of the distraction process and of the docking site between the techniques. Distraction parameters including external fixator (EF) time, external fixation index (EFI), and healing index (HI) were compared. Bone and functional results were compared according to the Paley-Maar classification. Complications associated with each procedure were compared.

Both BTON and BTOP achieved similar rates of primary union (83% vs. 89%) at the distraction or docking site. Significantly less time wearing an EF was needed for BTOP than for BTON (2.8 vs. 5.4 months; p < 0.01). The EFI was significantly lower for BTOP than for BTON (0.45 vs. 0.94 months/cm; p < 0.01), whereas the HIs were similar. The final outcomes and complication incidences were not significantly different.

The EF time was significantly shorter for BTOP than for BTON; however, the final outcomes were similar. Therefore, BTOP could be considered an attractive option for bone transport in patients with segmental tibial defects.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

To examine the feasibility of a novel anesthetic option for hip fracture fixation with short cephalomedullary nails.

Retrospective cohort study.

An urban, academic level 1 trauma center, a tertiary care academic medical center, and an orthopedic specialty hospitalPatients/Participants 20 recent and 40 risk-matched (111 by anesthesia type) historical hip fracture patients.

All patients with an OTA 31.A1-3 IT hip fracture presenting from October 1st 2019 - March 31st, 2020 treated with a short cephalomedullary nail (CMN) underwent a new intraoperative anesthesia protocol using monitored anesthesia care (MAC) and soft-tissue infiltration with local anesthesia (STILA).

Intraoperative measures, postoperative pain scores, narcotic and acetaminophen use, hospital quality measures, and inpatient cost.

A total of 60 patients (20 each MAC, general, spinal) were identified. There were differences among the groups regarding mean minimum and maximum intraoperative heart rate with MAC-STILA protocol demonstratiSee Instructions for Authors for a complete description of Levels of Evidence.

Therapeutic Level III. See Instructions for Authors for a complete description of Levels of Evidence.

To report functional outcome scores after operative intra-articular calcaneus fracture and to determine risk factors associated with worse outcomes.

Retrospective study.

Urban level 1 trauma center.

96 patients with 114 calcaneus fractures treated by a single-surgeon over a 14-year period.

Surgical treatment with open reduction and internal fixation (ORIF) with lateral extensile approach or percutaneous reduction and fixation.

Functional outcome scores as assessed by the Musculoskeletal Function Assessment (MFA) and the Foot Function Index (FFI) after mean 56 months follow-up.

72 patients (75%) completed functional outcome questionnaires. Patients with functional outcome data were more often employed (86% vs. 67%, p=0.07), but were no different in terms of age, sex, medical history, mechanism of injury or injury characteristics. Mean FFI score was 30 (range 2-89) and the mean MFA score was 28 (range 2-80). One third of patients reported scores >30 on the FFI, MFA or both. Age, sex, tobacco use, mechanism of injury, fracture pattern, open injury and post-operative infection were not associated with outcome scores. Alcohol abuse and failure to return to work were associated with worse (higher) FFI scores. Alcohol-abuse, psychiatric illness, unemployment (before and after injury), polytrauma and post-traumatic arthrosis (PTOA) were associated with worse (higher) MFA scores.

Polytrauma, alcohol-abuse, psychiatric illness, work status and PTOA were predictors of poor functional outcomes. The findings of this study add to prior literature that has demonstrated the importance of social, behavioral and environmental factors on recovery after orthopaedic injury.

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

To analyze the correlation between surgical timing and outcomes for calcaneus fractures treated using a sinus tarsi approach (STA).

Single Level-1 trauma center.

Retrospective.

Seventy consecutive intra-articular calcaneus fractures (OTA/AO 82C; Sanders II-IV) treated operatively using STA with a minimum of 1-year follow-up.

Open management using STA.

Surgery timing, wound complications, American Orthopaedic Foot and Ankle Society ankle and hindfoot and Patient-reported Outcomes Measurement System scores.

Patients were primarily men (68.6%) averaging 46 years (range, 18-77 years). Pilaralisib Nineteen (27%) were obese, 27 (38.6%) were smokers, and 3 (4.3%) were diabetic, and 10 (14.3%) had open fractures. Sanders III fracture patterns were most common (45.7%). Mean time to surgery was 4.9 days (range, 0-23 days). Three patients (4.2%) developed postoperative infections requiring surgical debridement and antibiotics. Forty patients (57%) underwent operative repair within 72 hours of injury, 9 (22.5%) of which had open fractures. Of this group, only one patient developed wound necrosis. Restoration of Bohler angle and angle of Gissane and reductions in calcaneal varus angle and heel width were achieved (all P < 0.001). No differences in Ankle Society ankle and hindfoot or Patient-reported Outcomes Measurement System scores were noted between patients treated within or beyond 72 hours from injury.

Intra-articular calcaneus fractures can be treated acutely within 72 hours of injury using STA with minimal wound complications and without compromising short-term functional outcome.

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Despite the popularity of Pilates exercises among postmenopausal women, few studies have devoted attention to verifying the effects of the technique on bone mineral density (BMD), and, to date, no systematic review and meta-analysis have been conducted on this topic. Our objective was to conduct a systematic review and meta-analysis of randomized controlled trials examining the effect of Pilates on BMD.

Randomized controlled trials were considered eligible, with follow-up of 6 months and more, which verified the effects of Pilates exercise on the BMD of postmenopausal women. The calculations of the meta-analysis were performed through the weighted mean difference between the Pilates exercise and control groups, through the absolute change between pre- and postintervention in the areal bone mineral density.

Three randomized controlled trials met the inclusion criteria and were included in the meta-analysis. Only 1 study presented satisfactory methodological quality. Pilates exercises did not offer significant effects to improve areal bone mineral density of the lumbar spine (0.