scholarly journals Profiling lower extremity injuries sustained in a state police population: a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kate Lyons ◽  
Mick Stierli ◽  
Ben Hinton ◽  
Rodney Pope ◽  
Robin Orr

Abstract Background Tactical populations, such as military, firefighter and law enforcement populations, are known to suffer a relatively high number of musculoskeletal injuries, with the lower extremity of notable concern. The aim of this retrospective cohort study was to determine the profile of lower extremity musculoskeletal injuries within a state police agency. Methods Injury data were collected by an Australian state police force over a 7-year period (2009–2016) and records not meeting the definition for lower extremity musculoskeletal injury were excluded. Statistical analyses were descriptive, with frequencies, means and standard deviations calculated where applicable. Chi-square analysis was performed to compare injury profiles by gender. Ethics approval was granted by Bond University Human Research Ethics Committee (Research Protocol 15360). Results Of the initial 65,579 incident records, 12,452 (19%) related to lower extremity musculoskeletal injuries. The knee was the most commonly injured site (31.4%) with sprains/strains (42.3%) the most common nature of injury and arresting offenders (24.2%) the most common activity at time of injury. Slips/trips/falls (37.8%) was found to be the most common cause of injury. Variations were found between genders, most notably within the injury activity (p < .001). 27.1% of male officers were injured when arresting offenders compared to 16.5% for female officers. Walking/running contributed to 17.9% of female officer incidents compared to 9.3% for male officers. The mean number of hours worked prior to injury occurrence was 6.00 ± 3.56 h with significantly more injuries occurring in the middle third of the shift (4.34–8.67 h, p < 0.001). Conclusions While the proportion of injuries that affected the lower extremity was lower for police, the leading sites of injuries (knees and ankles) were similar to those of military and fire and rescue populations. Variations between genders suggest there may need to be differences in return-to-work rehabilitation.

2014 ◽  
Vol 13 (2) ◽  
pp. 140-144 ◽  
Author(s):  
Jordan D. Lane ◽  
John Mugamba ◽  
Peter Ssenyonga ◽  
Benjamin C. Warf

Object Antibiotic-impregnated shunts have yet to find widespread use in the developing world, largely due to cost. Given potential differences in the microbial spectrum, their effectiveness in preventing shunt infection for populations in low-income countries may differ and has not been demonstrated. This study is the first to compare the efficacy of a Bactiseal shunt system with a non–antibiotic-impregnated system in a developing country. Methods The Bactiseal Universal Shunt (BUS) was placed in 80 consecutive Ugandan children who required a shunt. In this retrospective cohort study, the outcome for that group was compared with the outcome for the immediately preceding 80 consecutive children in whom a Chhabra shunt had been placed. The primary end points were shunt failure, shunt infection, and death. Shunt survival was analyzed using the Kaplan-Meier method. Significance of differences between groups was tested using the log-rank test, chi-square analysis, Fisher's exact test, and t-test. Results There was no difference between groups in regard to age, sex, or etiology of hydrocephalus. Mean follow-up for cases of nonfailure was 7.6 months (median 7.8 months, interquartile range 6.5–9.5 months). There was no significant difference between groups for any end point. The BUS group had fewer infections (4 vs 11), but the difference was not significant (p = 0.086, log-rank test). Gram-positive cocci were the most common culturable pathogens in the Chhabra group, while the only positive culture in the BUS group was a gram-negative rod. Conclusions These results provide equipoise for a randomized controlled trial in the same population and this has been initiated. It is possible that the observed trends may become significant in a larger study. The more complex task will involve determining not only the efficacy, but also the cost-effectiveness of using antibiotic-impregnated shunt components in limited-resource settings.


BMC Urology ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jake Herbert ◽  
Emily Teeter ◽  
Landen Shane Burstiner ◽  
Ralfi Doka ◽  
Amor Royer ◽  
...  

Abstract Background Inflammatory bowel diseases (IBD), like ulcerative colitis (UC) and Crohn’s disease (CD), are associated with urinary extra-intestinal manifestations, like urolithiasis and uncomplicated urinary tract infections (UTIs). The literature reviewed for this study identifies an increased association of CD and urolithiasis against the general population as well as UC. Furthermore, the rates in which urinary comorbidities manifest have not been well characterized in cross-race analyses. The purpose of this study is to establish the prevalence of common urinary extra-intestinal manifestations in CD and UC and to further determine at what rate these affect the African American and Caucasian populations. Methodology This is a retrospective cohort study using de-identified data collected from a research data base that included 6 integrated facilities associated with one tertiary healthcare center from 2012 to 2019. The electronic chart records for 3104 Caucasian and African American IBD patients were reviewed for frequency of urolithiasis and uncomplicated UTI via diagnosed ICD-10 codes. Comparison between data groups was made using multivariate regressions, t-tests, and chi square tests. Results Our study included 3104 patients of which 59% were female, 38% were African American, and 43% were diagnosed with UC. Similar proportions of UC and CD diagnosed patients developed urolithiasis (6.0% vs 6.7%, p = 0.46), as well as uncomplicated UTIs (15.6% vs. 14.9%, p = 0.56). Similar proportions of African American and Caucasian patients developed urolithiasis (5.4% vs 7.0%, p = 0.09), but a higher proportion of African Americans developed uncomplicated UTIs (19.4% vs 12.6%, p ≤ 0.001). Conclusion We found similar rates of urolithiasis formation in both UC and CD in this study. Furthermore, these rates were not significantly different between African American and Caucasian IBD populations. This suggests that UC patients have an elevated risk of urolithiasis formation as those patients with CD. Additionally, African Americans with IBD have a higher frequency of uncomplicated UTI as compared to their Caucasian counterparts.


Author(s):  
Chinmay N. Gokhale ◽  
Smita S. Chavhan ◽  
Balkrishna B. Adsul ◽  
Maharudra A. Kumbhar ◽  
Kirti V. Kinge ◽  
...  

Background: India was one of the leaders in terms of COVID-19 cases across year 2020. Hypothyroidism is one of the common morbidities that may influence prognosis of infectious diseases. However, some previously published literature had suggested that hypothyroidism may not be affecting outcomes of COVID-19 disease. Objective of this study was to analyze the outcomes of COVID-19 patients with pre-existing hypothyroidism and further suggesting determinants of worse outcomesMethods: This retrospective cohort study was carried out at one of largest Dedicated COVID-19 Hospital in Mumbai, India. Of the 16306 patients that got admitted at this hospital in year 2020, all those having hypothyroidism were included. Bivariate analysis was performed using Chi-square test and Multivariate analysis was performed using multiple logistic regression.Results: A total of 251 patients were having pre-existing hypothyroidism (1.54%). More females had hypothyroidism (73.7%) while death rate was more in males (26.3%). ICU admissions (27.5%) and death proportions (18.3%) were significantly more in hypothyroidism. Diabetes and hypertension were common concomitant Co-morbidities and odds ratios for death for diabetes group, hypertension group and diabetes+hypertension group were 4.9, 8.1 and 4.4 respectively in comparison to those having exclusive hypothyroidism.Conclusions: This study deals with an important topic of co-existing Hypothyroidism in COVID-19 patients and we can conclude that patients with Hypothyroidism must be considered to be at risk of severe outcomes. Furthermore, age, male gender and presence of concomitant Co-morbidities increase the risk of worse outcome.


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