The purpose of this study was to investigate the reported rates and characteristics of injuries among CrossFit athletes with specific attention to the hand and wrist. We further sought to identify trends and associations of these injuries by examining demographic data. Methods A questionnaire was created to capture self-reported information on the incidence of hand or wrist injuries and their associations in CrossFit athletes. It was distributed between April 2020 and July 2020 to athletes training at CrossFit affiliated gyms in the New York and Pennsylvania regions. Bivariate logistic regression analysis was used to identify factors correlated with an injury. Results A total of 270 responses (97.5% response rate) were available for final analysis. The median age of respondents was 34 years and 72.2% had been participating in CrossFit for at least two years. CrossFit athletes reported injury rates of 62.2% while engaged in CrossFit training and 20.4% reported an injury specific to the hand or wrist. The majority of hand or wrist injuries occurred after one year of CrossFit training (65.4%). The majority of reported initial injuries occurred to the wrist (75.4%); subsequently, 29.1% reported reinjuring the same region. While 58.2% reported not yet having healed or taking longer than one month to feel fully healed, 72.8% reported returning to unmodified training within one month. Only 15 respondents reported seeking medical attention from a physician for their injury. Physicians generally recommended a training break of over one month, but only two patients reported taking a break this long. Male sex and length of participation in CrossFit were associated with an increased risk of developing a hand or wrist injury. Discussion Hand and wrist injuries represent a significant proportion of injuries among CrossFit athletes. CrossFit practitioners are potentially returning to unmodified training too early following injury, leaving them susceptible to further injury. Physicians and therapists must consider these findings and address both therapies and preventative measures for these types of injuries with their patients.
Antibiotic resistance is a significant and growing public health problem. This work investigated the use of two different carbon nanomaterials, single-walled carbon nanotubes (SWNTs) and nanographene oxide (NGO), as a means of delivering the antibiotic tetracycline to a strain of Escherichia coli bacterium with an efflux pump resistance mechanism. Both SWNTs and NGO carrying tetracycline were found to inhibit the resistant strain of Escherichia coli, though the amount of tetracycline delivered was much lower than the minimum inhibitory concentration of free tetracycline. Attachment of the tetracycline to the nanomaterials was found to be necessary for the inhibition of bacterial growth, indicating that the nanomaterials were transporting the antibiotic into the cells and subverting the efflux pump. SWNTs were observed to have greater efficacy in delivering tetracycline than graphene oxide, which is attributed to the SWNTs’ needle-like shape. This work demonstrates both the use of carbon nanomaterials as antibiotic-delivery vehicles and the effect of nanomaterial shape on their efficacy. More importantly, it demonstrates that nanomaterials can successfully extend the life of existing antibiotics, making them an important tool for combatting antibiotic resistance mediated by an efflux pump mechanism.
Study Design. This is a retrospective cohort study. Objective. The aim was to evaluate differences in readmission rates, number of debridements, and length of antibiotic therapy when comparing bacterial gram type following lumbar spinal fusion infections. Summary of Background Data. Surgical site infections (SSIs) after spinal fusion serve as a significant source of patient morbidity. It remains to be elucidated how bacterial classification of the infecting organism affects the management of postoperative spinal SSI. Methods. Patients who underwent spinal fusion with a subsequent diagnosis of SSI between 2013 and 2019 were retrospectively identified. Patients were grouped based on bacterial infection type (gram-positive, gram-negative, or mixed infections). Poisson regressions analyzed the relationship between the type of bacterial infection and the number of irrigation and debridement (I&D) reoperations, and the duration of intravenous (IV) antibiotic therapy. Significance was set at P<0.05 Results. Of 190 patients, 92 had gram-positive (G+) infections, 57 had gram-negative (G−) infections, and 33 had mixed (M) infections. There was no difference in 30 or 90-day readmissions for infection between groups (both P=0.051). Patients in the M group had longer durations of IV antibiotic treatment (G+: 46.4 vs. G−: 41.0 vs. M: 55.9 d, P=0.002). Regression analysis demonstrated mixed infections were 46% more likely to require a greater number of debridements (P=0.001) and 18% more likely to require an increased duration of IV antibiotic therapy (P<0.001), while gram-negative infections were 10% less likely to require an increased duration of IV antibiotic therapy (P<0.001) when compared with G− infections. Conclusion. Spinal SSI due to a mixed bacterial gram type results in an increased number of debridements and a longer duration of IV antibiotics required to resolve the infection compared with gram-negative or gram-positive infections. Level of Evidence. Level III.
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