Epidemiology Study: Incidence and Prevalence

Background: Hand and wrist injuries are a common but underestimated issue in taekwondo. Detailed data on injury risk, patterns, and mechanism are missing. Purpose: To evaluate (1) the fight time exposure-adjusted injury incidence rate (IIR) and clinical incidence and (2) injury site, type, sport-specific mechanism, and time loss in taekwondo. Study Design: Descriptive epidemiology study. Methods: Athletes from a single national Olympic taekwondo training center were investigated prospectively for hand and wrist injuries during training and competition over 5 years. The Orchard Sports Injury Classification System Version 10 was used to classify injury type, and analysis of the anatomic injury site was performed. The mechanism of injury was classified as due to either striking or blocking techniques. Results: From a total of 107 athletes, 79 athletes (73.8%) with a total exposure time of 8495 hours were included in the final data set. During the study period, 75 injuries of the hand and wrist region were recorded despite the athletes using protective hand gear. The IIR was 13.9 (95% CI, 10.5-17.5) and was significantly higher during competition. The clinical incidence as an indicator for risk of injury was 60.7% (95% CI, 50.9-70.5). Finger rays were the most affected location (68%), and fractures (43%) and joint ligament injuries (35%) were the most common type of injury. Significantly more injuries were found on the dominant hand side ( P < .001). Comparison of injury mechanisms demonstrated significantly more injuries at the finger rays deriving from blocking techniques ( P = .0104). The mean time loss for all hand and wrist injuries was 15.7 ± 13.5 days (range, 3-45 days) and was highest for distal radial fractures, with a mean of 39.7 ± 4.8 days (range, 32-45 days). Conclusion: There was a significantly higher IIR for acute hand and wrist injuries in elite taekwondo athletes during competition, which resulted in considerable time loss, especially when fractures or dislocations occurred. Significantly more injuries to the finger rays were found during blocking despite the use of protective hand gear. Improvement of tactical skills and blocking techniques during training and improved protective gear appear to be essential for injury prevention.

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Impact of Removing the Race Coefficient in Renal Function Estimate Equations on Drug Dosage Recommendations

Annals of Pharmacotherapy ◽

10.1177/10600280211010228 ◽

2021 ◽

pp. 106002802110102

Author(s):

Janine Miller ◽

John P. Knorr

Keyword(s):

Filtration Rate ◽

Drug Dosage ◽

Drug Dose ◽

Epidemiology Study ◽

Black African ◽

Drug Dosing ◽

Disease Epidemiology ◽

Black Patients ◽

The Impact ◽

Level Of Agreement

Background The appropriateness of including the race coefficient in glomerular filtration rate (GFR) equations in Black patients is debated, and the impact on drug dosing is unknown. Objective This study explored the impact of removing the race coefficient on drug dosing in Black patients in comparison to conventional methods. Methods This was a retrospective study of hospitalized patients who self-identified as Black/African American and were prescribed an antimicrobial that includes renal dosage recommendations in the product labeling. The primary end point was the discordance between drug dosing recommendations derived by body surface area deindexed GFR estimated by the CKD-EPI equation (Chronic Kidney Disease Epidemiology study) with and without race versus recommendations derived from Cockcroft-Gault (CG). Results A total of 210 Black patients were included. There was an 18% rate of discordance when GFR was estimated with the race coefficient (GFR w/Race) versus without the race coefficient (GFR w/out Race). GFR w/out Race had a higher level of agreement with dosing by creatinine clearance (CrCl; κ = 0.779) than GFR w/Race versus CrCl (κ = 0.651). GFR w/out Race had less within-patient difference than GFR w/Race in comparison to CrCl (mean difference: −6.3 vs −18.0 mL/min). Conclusions and Relevance This represents the first report to examine the removal of the race coefficient and its implication on drug dose discordance. GFR w/out Race had a higher level of agreement and less drug dose discordance than GFR w/Race, in comparison to CrCl estimates. If GFR equations are considered comparable to CrCl for the purposes of guiding drug dosing, GFR w/out Race should be considered.

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EPID-10. EPIDEMIOLOGY STUDY OF UNCOMMON CHILDHOOD BRAIN TUMOURS IN ASIAN CHILDREN

Neuro-Oncology ◽

10.1093/neuonc/noaa222.196 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii320-iii320

Author(s):

Godfrey Chi-Fung Chan ◽

Anthony Pak-Yin Liu ◽

Matthew Ming-Kong Shing ◽

Dennis Tak-Noi Ku

Keyword(s):

Choroid Plexus ◽

Brain Tumours ◽

Clinical Characteristics ◽

Interferon Beta ◽

Choroid Plexus Papilloma ◽

Epidemiology Study ◽

Childhood Brain Tumours ◽

Post Surgery ◽

Asian Children ◽

Multiple Recurrences

Abstract Our local registry identified 656 brain tumours from Jan 1999 to Dec 2018, (incidence: 29.8/yr/million). Other from Glioma, Medulloblastoma/PNET, Germ Cell tumours, Ependymoma, the remaining rarer tumours accounted for 18% (n=118). The 7 more common groups are: craniopharyngioma(n=28); ATRT(n=18); choroid plexus papilloma/CA(n=12); Ganglioglioma(n=11); ETMR(n=7); DNET(n=7); meningioma(n=6). Their respective incidences are 1.27; 0.81; 0.55; 0.5; 0.32; 0.32 0.27/yr/million. For craniopharyngioma, M:F=15:13 and median age was 7.4yrs (2mons-16.5yrs). 12/28 children had surgery alone and 13/28 had focal RT post-surgery with better outcome. 3 underwent intra-cystic interferon-beta also stable. For ATRT, M:F=7:8 and median age was 2.3yrs (4mos-14.2yrs). 2 had metastatic disease and 7/18 patients remained alive. For choroid plexus tumours, there were 7 papilloma, 2 atypia and 3 carcinoma. M:F=5:6 and median age was 1.5yrs (4mos-14yrs). All papilloma, 1/2 atypia and 1/3 carcinoma survived. For ganglioglioma, M:F=7:4 with median age of 5.5yrs (5mos-13.2yrs). They commonly presented with seizure and only one died (brainstem primary). The ETMR includes ependymoblastoma and medulloepithelioma, they had quite different clinical characteristics and outcome. 6/7 DNET had convulsion and M:F=6:1. Median age was 11.5yrs (2.66-14yrs). They all survived even if incompletely resected. For meningioma, 1/6 had germline mutation of NF-2 gene. M:F=3:3 and onset was >8yrs except the NF-2 patient. All survived but the NF-2 had multiple recurrences. 4 patients developed secondary meningioma due to irradiation but they were >18yrs so excluded. In summary, rarer forms of childhood brain tumours only accounted for <20% of all brain tumours and they had diverse presenting features and outcome.

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