Pittsburgh Air Pollution Changes During the COVID-19 Lockdown.

The rapid spread of COVID-19 resulted in various public lockdowns across the globe. Previous studies showed that resultant travel restrictions improved air quality. The novel results presented here focus on source-specific changes and compare air quality for multiple years controlled for precipitation.

Impact of Low-Cost Point-of-Use Water Treatment Technologies on Enteric Infections and Growth among Children in Limpopo, South Africa.

Enteric infections early in life have been associated with poor linear growth among children in low-resource settings. Point-of-use water treatment technologies provide effective and low-cost solutions to reduce exposure to enteropathogens from drinking water, but it is unknown whether the use of these technologies translates to improvements in child growth. We conducted a community-based randomized controlled trial of two water treatment technologies to estimate their effects on child growth in Limpopo, South Africa.

Challenges to Sustainable Safe Drinking Water: A Case Study of Water Quality and Use across Seasons in Rural Communities in Limpopo Province, South Africa.

Consumption of microbial-contaminated water can result in diarrheal illnesses and enteropathy with the heaviest impact upon children below the age of five. We aimed to provide a comprehensive analysis of water quality in a low-resource setting in Limpopo province, South Africa. Surveys were conducted in 405 households in rural communities of Limpopo province to determine their water-use practices, perceptions of water quality, and household water-treatment methods.

Understanding and Perception of Overlapping Surgery in an Orthopaedic Trauma Population: A Survey Study.

Introduction: Recently, overlapping surgery has received attention on the national scale. This study quantifies orthopaedic trauma patients' familiarity and concern with overlapping surgery as it relates to their care.

Methods: A 15-question survey was voluntarily completed by 200 orthopaedic trauma patients in the outpatient setting of a level I trauma center.

Computer-assisted surgery: The use of stored intraoperative images for accurate restoration of femoral length and rotational alignment after fracture.

Most femoral fractures are now managed with minimally invasive internal fixation. In the absence of formal exposure of the fracture lines, these procedures make heavy use of C-arm fluoroscopy to allow both fracture reduction and placement of implants, at the expense of measurable radiation exposure to both patient and surgeon. Although this technology has been commercially available for over a decade, it has not yet been widely accepted by the Orthopaedic community.

Screw placement for acetabular fractures: which navigation modality (2-dimensional vs. 3-dimensional) should be used? An experimental study.

Objectives: Screw navigation techniques with different image guidance [2-dimensional (2D) vs. 3-dimensional (3D) fluoroscopy] were evaluated for acetabular fracture surgery.

Methods: Two-dimensional and 3D navigation images were analyzed for visualization of different osseous corridors: supra-acetabular, anterior column, posterior column, and infra-acetabular.

Fluoro-Free navigated retrograde drilling of osteochondral lesions.

Purpose: Retrograde drilling of osteochondral lesions (OCLs) is a recommended, but demanding operative approach for revascularization of lesions in stage 1-3 according to Berndt and Harty after failed conservative treatment. The gold standard of intraoperative driller guidance is fluoroscopic control. Limitations are a 2D visualization of a 3D procedure and sometimes limited view of the OCL in fluoroscopy, leading to increased radiation exposure.

Navigated long-bone fracture reduction.

The first computer-assisted orthopaedic trauma procedures were limited to navigated drill-guide applications, in which the computer was used to predict the trajectory of the drill guide relative to stored radiographic images. By 2003, software for fracture reduction was commercially available. The ability to perform a minimally invasive fracture reduction with the aid of stored images, combined with navigated insertion of internal fixation, has long been considered the highest achievement in image-guided fracture surgery.

A comparison of optical and electromagnetic computer-assisted navigation systems for fluoroscopic targeting.

Objectives: Freehand targeting using fluoroscopic guidance is routine for placement of interlocking screws associated with intramedullary nailing and for insertion of screws for reconstruction of pelvic and acetabular injuries. New technologies that use fluoroscopy with the assistance of computer guidance have the potential to improve accuracy and reduce radiation exposure to patient and surgeon. We sought to compare 2 fluoroscopic navigation tracking technologies, optical and electromagnetic versus standard freehand fluoroscopic targeting in a standardized model.

Mechanisms and management of stress fractures in physically active persons.

Objective: To describe the anatomy of bone and the physiology of bone remodeling as a basis for the proper management of stress fractures in physically active people.

Data Sources: We searched PubMed for the years 1965 through 2000 using the key words stress fracture, bone remodeling, epidemiology, and rehabilitation.

Data Synthesis: Bone undergoes a normal remodeling process in physically active persons.

Traumatic hemipelvectomy: case report and literature review.

Traumatic hemipelvectomy is a rare but devastating injury involving complete disruption of the hemipelvis from the pubic symphysis to the sacroiliac joints and often results in death. We present an interesting case of traumatic hemipelvectomy caused by a previously undescribed mechanism of injury in which judicious angiography and aggressive surgical treatment contributed to patient survival.

Supra-acetabular placement of external fixator pins: a safe and expedient method of providing the injured pelvis with stability.

Applying a stable anterior pelvic external fixator frame is a skill that should be mastered by all orthopedic surgeons who treat acutely injured patients. Splinting of an unstable pelvis during resuscitation can help to reduce the volume of the true pelvis, pending definitive surgical stabilization of the pelvic ring. Supra-acetabular pin placement, less familiar to most surgeons than iliac wing pin placement is, can provide a more reliable pin-bone interface and thus allow improved reduction ability with fewer soft-tissue complications.

Image guidance: fluoroscopic navigation.

Computer-assisted orthopaedic surgery slowly is making its way into routine orthopaedic practice. Orthopaedic trauma has long been identified as a potential impact area of this new technology. Early experience with three-dimensional (3D) image-guided surgery was promising, but this particular technique was limited by the inability to update the 3D computer model in the operating room after fracture reduction maneuvers or implant placement.

Creatine Supplementation Increases Total Body Water Without Altering Fluid Distribution.

OBJECTIVE: To examine the effects of oral creatine (Cr) monohydrate supplementation on muscle Cr concentration, body mass, and total body water (TBW), extracellular water (ECW), and intracellular water (ICW) volumes. DESIGN AND SETTING: After an overnight fast, urinary Cr and creatinine concentrations, muscle Cr concentration, body mass, TBW, ECW, and ICW were measured, and subjects were randomly assigned to either a Cr or a placebo (P) group. The Cr group ingested 25 g/d of Cr for 7 days (loading phase) and 5 g/d for the remaining 21 days (maintenance phase), whereas the P group ingested a sucrose P using the same protocol.

Closed reduction and percutaneous fixation of anterior column acetabular fractures.

Objective: The current standard treatment of anterior column acetabular fractures includes formal open reduction with internal fixation (ORIF) through a variety of anterior approaches. These approaches have been associated with significant blood loss, infection, lengthy operative times, and neurovascular complications. It therefore seems reasonable to consider less invasive alternatives to conventional treatment methods.