CJSM Podcast 24 — A conversation with Christina Master, M.D. about vision/vestibular dysfunction in children post-concussion

Christina L. Master, M.D. speaking on her work on vision and vestibular dysfunction at recent AMSSM 2018 conference.

“Invest a little time; get a lot of information.”

So says the guest for our newest podcast — Christina L. Master, M.D., pediatric sports medicine specialist at the Children’s Hospital of Philadelphia, and Professor of Clinical Pediatrics at the Perelman School of Medicine, University of Pennsylvania–in reference to the physical examination for sports-related concussions (SRCs)

If you attended her lecture at AMSSM 2018 I am sure you were as suitably impressed as I was:  Dr. Master is a masterful speaker, and she gave a memorable presentation on the importance of a focused oculomotor exam in the evaluation of pediatric SRCs.

She exhorted the clinicians in the audience to consider a move away from a primarily symptom-based evaluation of their pediatric patients, to one which is more oriented toward looking for physical signs of visual and vestibular dysfunction — in as little as two minutes, a physical exam can provide the clinician with vitally important information.

Not coincidentally, we had just published one of her more recent publications on this very subject in our March 2018 issue: Vision & Vestibular Dysfunction Predict Prolonged Recovery in Children. We thought it would be the perfect time then to have Dr. Master as our podcast guest; the trick was to track her down in all the comings and goings of AMSSM 2018.  We succeeded.

In the podcast, she discusses her research on physical exam findings of vision and vestibular dysfunction which aid in the diagnosis, prognosis, and management of pediatric sport-related concussion.

Take a listen to our conversation: as ever you can find our podcasts on our main webpage or, better yet, subscribe to them on iTunes Read the study itself…..AND…..I’d encourage you to take the CME module covering Dr. Master’s work.

“Invest a little time; get a lot of information.” So true.  Both in the examination room with our patients, and here with us at CJSM.

 

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Concussions in Professional Football

It’s a new year and we have a new podcast to add to the growing collection of CJSM podcasts which can be found on our main website [or, better yet, by subscribing to our podcast feed on iTunes].

Our guest this month, J. Scott Delaney M.D., is an Associate Professor and the Research Director, Department of Emergency Medicine, McGill University Health Centre (MUHC) and McGill Sport Medicine Clinic in Montreal, Canada.

Scott Delaney, M.D.

He is also the physician for several university and professional teams, including the Montreal Alouettes of the Canadian Football League (CFL).  In that role, he headed research on concussion awareness among professional football players, work that has just been published in the January 2018 issue of CJSM.

The study has already received considerable media exposure as it sheds light, at the highest level of play, on the behavior and motivation of athletes to report possible concussions.

Listen to the podcast conversation we just had with Dr. Delaney.  Find out why, when it comes to concussions, “It takes a village to make the diagnosis.”  And, as ever, join in the emerging conversation about this work by making comments on this blog or going to our Twitter feed and chatting up @CJSMOnLine

 

Disparities in sports medicine health care

Most days of the week I see my pediatric sports medicine patients in two very different clinics:  one is within the inner city of Columbus, Ohio itself; and one is in the foothills of Appalachia, a region described in the recent bestseller, Hillbilly Elegy.  Among the patients I frequently see, I have many who could be described as urban poor (the former location), and many as rural poor (the latter).

In my care of these patients, I frequently see them (and their families) struggle with several barriers to excellent care — these range from financial issues, to issues of transportation and distance traveled, to issues of understanding related to educational levels, to a relative lack of resources at their home schools or clubs (e.g. no certified athletic trainers).  I feel at a great loss, at times, in trying to help them achieve the same results I would want for any of my patients.

I read with great interest then, in the November 2017 CJSM, a newly published, original research study: Disparities in Athletic Training Staffing in Secondary School Sport: Implications for Concussion Identification.  I found it so impactful, that I wanted to talk with the author — and so I tracked down Emily Kroshus ScD, MPH for this episode of the CJSM podcast.

Dr. Kroshus is a Research Assistant Professor of Pediatrics at the University of Washington, who is developing a body of academic work that focuses on “….identifying social and contextual determinants of help seeking behaviors, with an overarching interest in addressing disparities related to gender, race, sexual orientation, and socioeconomic status.”(1)

I hope you are as interested in this sort of research as much as I am.  So take a listen to the podcast on iTunes or go to the CJSM website for the podcast (look for the radio button) and the study itself.

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(1) Dr. Kroshus’ biography can be found at the University of Washington faculty page:  https://depts.washington.edu/uwgenped/directory/emilykroshus

Deck the halls.

Advent is here — a time of anticipation.  When I was a child, my mother would get all of us children an Advent Calendar, and each day I’d eagerly open up the windows of the calendar to find the chocolate inside.  You too?

I enjoy the holiday spirit that inspires many of the people/organizations I follow on social media.  Even the staid ones play with the mistletoe, so to speak.  The British Medical Journal (BMJ), for instance, puts on the holly and the ivy, and has a very clever, festive theme on its Twitter feed for the month of December:  a daily “Christmas Cracker,”(#BMJChristmasCrackers) that leads one to ponder issues like…whether Santa is a healthy role model or whether eating turkey really can make one sleepy.

Not quite Advent chocolate, but, at my age, I could use something low calorie. As the saying goes, you can’t outrun a bad diet (and, furthermore, I can’t run any more).

We, too, get festive this time of year at CJSM, notwithstanding the hard work our Editor-in-Chief (EIC) Chris Hughes will be doing throughout the Yuletide season taking care of his charges as a team physician for a Premiership football side. While you (and I) will likely be enjoying a quiet Boxing Day, he (and many team docs) will be taking care of business for the sides they cover.

Our elves busy at work packaging up the next edition of CJSM

Our last issue of the year (published in November)  is a bit like an Advent Calendar — open up the pages of the issue, and you’ll find a veritable smorgasbord of interesting topics to sample.  One I particularly liked explores disparities in access to athletic trainers and how this impacts concussion management in high school athletes.  The EIC himself has given a nod to a systematic review on the treatment of acute patellar dislocation.

Too busy to read because you’re travelling?  We’ll have a new podcast to add soon to the ever growing list of ones CJSM has already posted to iTunes.  So subscribe to the feed and listen to your heart’s content.

Whatever your plans this Season, if you are in sports medicine, be sure to include CJSM along with the requisite eggnog and fruitcake.

Ho ho ho!!!!

 

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