Treatment of Brachioradial Pruritus: A Tertiary Center Retrospective Analysis.

This retrospective study investigates the efficacy of 2 treatment regimens, pregabalin alone versus pregabalin combined with ketamine, amitriptyline, and lidocaine cream, in reducing itch in patients with brachioradial pruritus at a tertiary care center. Electronic medical records of 64 brachioradial pruritus patients seen at the University of Miami Itch Center were analyzed. A significant reduction in itch scores was seen with both treatments, with no significant difference between the groups. A small number of patients experienced adverse effects, including drowsiness and weight gain with pregabalin and skin irritation with ketamine, amitriptyline, and lidocaine cream. Ultimately, our findings underscore the potential of utilizing combined therapy for difficult-to-treat brachioradial pruritus cases and implementing individualized approaches for managing neuropathic pruritus. Further controlled clinical trials are needed to establish optimal treatment protocols.

Effects of COVID-19 on Rate of Injury and Position-Specific Injury During the 2020 National Football League Season.

ABSTRACT: Costello II, JP, Wagner, JD, Dahl, VA, Cohen, JL, Reuter, AM, and Kaplan, LD. Effects of COVID-19 on rate of injury and position-specific injury during the 2020 National Football League season. J Strength Cond Res 38(1): 97-104, 2024-Because of the COVID-19 pandemic, the National Football League (NFL) made changes to its operations for the 2020 season. We hypothesize an increase in the rate of injuries during the 2020 season. Publicly available data were reviewed to identify NFL injuries from the 2015-2020 seasons. Player position, description of injury, date of injury, and injury setting were recorded. p ≤ 0.05 was considered statistically significant. For the 2020 season, compared with the 2015-2019 seasons, there was an increased risk of injury during the regular season overall relative risk (RR) = 1.308 ( p < 0.05), week (W)1 RR = 7.33 ( p < 0.05), W1-6 RR = 1.964 ( p < 0.05), W7-12 RR = 1.8909 ( p < 0.05), and during the postseason overall RR = 1.1444 ( p < 0.05), calculated using analysis of variance. There was an overall increased risk of abdominal or core injuries RR = 1.248 ( p < 0.05), groin or hip injuries RR = 2.534 ( p < 0.05), and hamstring injuries RR = 3.644 ( p < 0.05). There was an increased risk of hamstring injuries in cornerbacks RR = 3.219 ( p < 0.05) and running backs RR = 1.1394 ( p < 0.05), hip or groin injuries in guards RR = 1.105 ( p < 0.05), Achilles tendon injuries in safeties RR = 1.6976 ( p < 0.05), quadriceps injuries in running backs RR = 1.6191 ( p < 0.05), and arm injuries in defensive tackles RR = 1.221 ( p < 0.05). There was an increase in the overall rate of injuries in the 2020 NFL season, both in the regular season and postseason, compared with the 2015-2019 seasons. The overall rate of abdominal or core, groin or hip, and hamstring injuries increased. Specific player positions saw unique increases in rates of injuries. These findings may be due to numerous operational changes implemented, such as reduced in-person training and the elimination of the preseason, leading to suboptimal, sports-specific conditioning and increased risk of musculoskeletal injury.

The Effects of Modified Game Schedules on Injury Rates in the National Hockey League (NHL).

Background Due to the COVID-19 pandemic, many professional sports leagues such as the National Hockey League (NHL) made significant changes to their schedules and operating procedures. Changes included a modified 2019-2020 playoff format, the removal of the 2020-2021 preseason, and condensed game schedules. Though these modifications were made in an effort to protect players from COVID-19, they resulted in decreased training time and preparation. The purpose of this study was to assess the impact of these changes on the rate of player injuries in the NHL both after the resumption of the midseason stoppage and during the subsequent seasons. Hypothesis/purpose Changes to the NHL schedule amid the COVID-19 pandemic resulted in a significant increase in player injury rates. Methods NHL injuries were obtained from an NHL injury database for the 2018-2019 through the 2021-2022 seasons. The date of injury, date of return, injury description, player age, and player position were recorded. Injury rates were calculated as the number of total athlete injuries per 1000 game exposures (GEs). The primary outcome was the injury proportion ratio (IPR) when comparing the injury rates of the post-COVID-19 season with baseline seasons. Secondary measures analyzed injuries based on age, anatomic location, month in the season, position, length of injury, season-ending injuries, and recurring injuries. Results A total of 4604 injuries were recorded between 2018 and 2022. The modified 2019-2020 playoffs had significantly higher rates of injury (IPR = 1.84, 95% confidence interval {CI} = 1.36-2.49) with more game exposures per week. The 2020-2021 season had significantly higher rates of overall player injury compared to baseline seasons (IPR = 1.19, 95% CI = 1.09-1.30) and also had a higher rate of season-ending injuries (IPR = 1.71, 95% CI = 1.38-2.11). Most injuries occurred in the first few months of the 2020-2021 season. There was no significant difference in injury rate based on age group and no significant difference in the average length of injury between seasons. Conclusion Increases in injury rates could be due to decreased offseason training between seasons, the elimination of preseason games, and increased game density. Decreasing typical training timelines and eliminating the preseason to rapidly return to normal competition after unexpected events (pandemics, lockdowns, etc.) may pose a risk to player safety in the NHL. These findings should be considered before future schedule changes in professional hockey.

Epidemiology and survival factors for sarcoma patients in minority populations: a SEER-retrospective study.

Background: Epidemiologic studies have demonstrated race as a predictor of worse oncological outcomes. To better understand the effect of race on oncological outcomes, we utilized the Surveillance, Epidemiology, and End Results (SEER) database to determine what treatment courses are provided to minority patients and how this impacts survival. Materials and methods: A retrospective review of bone and soft tissue sarcoma cases was performed using the SEER database for a minimum 5-year survival rate (SR) using Kaplan-Meier curves. Categorical variables were compared using Pearson's χ2 test and Cramer V. Kaplan-Meier curves were used to determine survival rates (SR) and Cox regression analysis was used to determine hazard ratios (HRs). Results: Races that had an increased risk of death included Native American/Alaska Native (NA/AN) [hazard ratio (HR): 1.36, 95% confidence interval (CI): 1.049-1.761, p = 0.020) and Black (HR = 1.17, 95% CI: 1.091-1.256, p < 0.001). NA/AN individuals had the lowest SR (5-year SR = 70.9%, 95% CI: 63.8-78.0%, p < 0.001). The rate of metastasis at diagnosis for each race was 13.07% - Hispanic, 10.62% - NA/AN, 12.77% - Black, 10.61% - Asian/Pacific Islander (A/PI), and 9.02% - White individuals (p < 0.001). There were increases in the rate of metastasis at diagnosis and decreases in rates of surgical excision for Hispanic and Black patients (p < 0.001). Conclusion: Race is determined to be an independent risk factor for death in NA/AN and Black patients with sarcomas of the extremities. Access to healthcare and delay in seeking treatment may contribute to higher rates of metastasis upon diagnosis for minority patients, and decreased rates of surgical excision could be associated with poor follow up and lack of resources.

The efficacy of patient specific instrumentation (PSI) in total hip arthroplasty (THA): A systematic review and meta-analysis.

Background: Patient-specific instrumentation (PSI) has been suggested to reduce improper component positioning, though the effectiveness of PSI in total hip arthroplasty (THA) remains inconclusive. The purpose of this study was to evaluate the radiographic parameters and clinical outcomes comparing PSI and standard instrumentation (SI). Methods: This systematic review and meta-analysis was conducted in accordance with the 2020 PRISMA statement and was registered on PROSPERO. PubMed, Embase, Scopus, Google Scholar, and ClinicalTrials.gov were searched for relevant studies pertaining to the use of PSI in THA. Inclusion criteria included PSI used in THA, PSI was directly compared to SI, and publication in English. Exclusion criteria included non-primary THA, review articles, abstracts, book chapters, and animal models. Results: 2,458 studies were initially identified, with 13 studies (677 THAs: 338 controls, 339 PSI) meeting all criteria. PSI was favored for the deviation from the preoperative plan for acetabular cup position for anteversion (p = 0.04) and inclination (p = 0.0002); risk of acetabular cup positioning outside the Lewinnek safe zone for anteversion (p = 0.005) and inclination (p < 0.0001); and postoperative Harris Hip Score (p = 0.0002). No significant differences were found for the deviation from the preoperative plan for femoral stem position for anteversion (p = 0.74) or varus/valgus (p = 0.15); intraoperative time (p = 0.55); or intraoperative blood loss (p = 0.62). Conclusion: The use of PSI in THA is effective in improving acetabular component positioning and postoperative functional outcomes, without increasing intraoperative time or blood loss, compared to SI.