Thoracic Transillumination: Aid in the Diagnosis and Treatment of Pneumopericardium

A frequent complication of continuous positive airway pressure and mechanical ventilation used to treat neonates who have hyaline membrane disease and other forms of respiratory distress is an air leak from alveolar rupture. Pneumothorax and pneumomediastinum are common. Pneumopericardium does not occur often, but it can be life-threatening if it produces acute cardiac tamponade. In a review of the literature, Brans and associates1 found that pneumopericardium in neonates was treated by pericardiocentesis in one half of the published cases; 79% of them survived or they ultimately died of complications unrelated to pericardial tamponade. However, only 32% of the infants treated conservatively survived.</jats:p

Osteopathic Orthopaedic Residency Selection Criteria: Program Directors’ Survey and Analysis

CONTEXT Orthopaedic Surgery has become one of the most competitive specialties. Each year the number of applicants is far greater than the number of available Orthopaedic residency training spots [1,2,3]. With medical schools expanding their class sizes and new medical schools opening out of proportion to the number of residency spots, the competition is becoming even more fierce [12]. There are several published articles on resident selection in allopathic orthopaedic programs [5-7]. However, there are currently no such published studies on osteopathic orthopaedic programs to our knowledge. With the AOA and ACGME merger, this topic is critical to both allopathic and osteopathic applicants alike. The goal of our study was to evaluate the resident selection criteria for osteopathic orthopaedic residency programs. METHODS A twenty-five-question survey was sent to all of the osteopathic orthopaedic programs in December of 2017. The most important selection factors were then calculated as a mean of all the responses and were ranked accordingly. RESULTS The survey was completed by 29 out of 41 program directors (71%). The most important factors in resident selection were performance during the student’s rotation at the program, formality/politeness and performance in the interview, and medical school board exam scores. CONCLUSIONS This study is the most comprehensive study to date on the osteopathic orthopaedic resident selection process. The results from this study will help future applicants, both MD and DO, to focus on the factors in resident selection. The results may also help programs evaluate their own selection process and make improvements. </jats:sec

Knee Focalplasty for Partial Tibial or Femoral Resurfacing Using 3-Dimensional−Printed Titanium Implants

Articular cartilage lesions of the knee are common and can lead to persistent symptoms of pain, swelling, and limitations in activity for many active individuals. In the middle-aged patient, cartilage repair options have been shown to have greater failure rates. Total or unicompartmental knee arthroplasty also can be considered but may be undesirable for active patients because of the morbidity of the procedure as well as postoperative activity limitations. Focalplasty is a minimally invasive technique to treat focal chondral and osteochondral lesions of the knee with 3-dimensional−printed porous titanium implants that allow for bony ingrowth and immediate weight-bearing. This technical note demonstrates implantation technique for both the tibial and femoral implants for application in focal tibiofemoral disease

Analysis of Type I and III interferon levels in the sera of normal and autoimmune donors. (101.37)

Abstract We have begun examining serum levels of Type I and III interferons in normal and autoimmune donors by ELISA and a Type I reporter gene activity assay to determine if there are expression pattern signatures of these diseases. Samples were obtained from normal donors and patients with Systemic Lupus Erythematosus, Rheumatoid Arthritis or Multiple Sclerosis and assayed for IFN-α), IFN-β, IFN-ω, and IFN. Normal controls had little detectable IFN-α, IFN-ω, or Type I IFN activity. Low levels of IFN-β were detected in 15% of the normal controls. Approximately 35% of the normal controls had detectable IFN-λ. In the Lupus samples, 45% had detectable IFN-α. IFN-ω and IFN-β were detected in 20 and 40%, respectively, of the Lupus samples. Overall, greater than 80% of the Lupus samples had detectable Type-I IFN. Rheumatoid arthritis samples may have elevated IFN-β and IFN-ω relative to normal controls, but not IFN-α. Multiples sclerosis samples had a slight tendency towards elevated IFN-β. A low percentage of Lupus and multiple sclerosis samples had detectable Type-I IFN activity by the reporter gene assay. None of the samples displayed significant differences in Type III IFN expression. Multiplex ELISA was used to examine a subset of the samples for cytokine profiles and in Lupus samples IL-13 was decreased. In arthritis samples IL-8 and IL-23 were elevated, while in Multiple Sclerosis samples IL-2, IL-4 and IL-10 were elevated. The implications of these results will be discussed.</jats:p