CJSM May 2021 Journal Club — Blood Biomarkers in Pediatric Concussions

The May 2021 CJSM issue has just published, and as always it is full of articles you will want to read.

As I gaze at the table of contents, a non-random sampling of eye catching articles includes

CJSM Junior Associate Editor Jason Zaremski, MD breaks it all down for us.

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Clinical Journal of Sports Medicine

Online Journal Club May 2021

CJSM Junior Associate Editor Jason Zaremski, MD

Jason L Zaremski, MD, CAQSM, FACSM, FAAPMR

Anzalone AJ, et al. Blood Biomarkers of Sports-Related Concussion in Pediatric Athletes.

Introduction:  There has been a substantial amount of interest in the diagnosis, evaluation, and management sports related concussions (SRC) in the past decade. An emerging area of interest has been the study of biomarkers as a more objective measure of head trauma. Two blood biomarkers — Neurofilament light polypeptide (Nf-L), primarily found in axons, and Tau, a microtubule-associated protein necessary for axonal transport — have been studied at advanced level of sport (collegiate, professional, and Olympic athletes).

The authors of this new study evaluated these blood biomarkers in pediatric athletes.  The main outcome measures they looked at were correlations between self-reported symptom measures biomarker concentration levels.

Purpose/Specific Aims: The authors examined patterns of blood biomarker concentrations (tau and Nf-L) in pediatric athletes seen in clinic in the days following a SRC and at a six-month follow up.  A comparator group of non-injured controls were assessed as well.  Correlations between biomarker concentrations and self-reported symptom scores were assessed. Read more of this post

Youth Sports Specialization in the United States — a Podcast with Dr. Stephanie Kliethermes

The most recent annual meeting of the American Medical Society for Sports Medicine (AMSSM2021) was a smashing (and virtual) success.

The March 2021 Clinical Journal of Sport Medicine highlights plenty of the work presented at AMSSM2021, with the publication of many of the research and case abstracts presented at the meeting.

The same issue also sees published one of the AMSSM’s most recent publications:  Defining a Research Agenda For Youth Sport Specialization in the United States:  the AMSSM Youth Early Sport Specialization Summit

The lead author of this publication, Stephanie Kliethermes, PhD, is the Director of AMSSM’s Collaborative Research Network, which has become a body which produces a considerable amount of sports medicine research.

Dr. Stephanie Kliethermes — researcher, glacier explorer

CJSM values its partnership with AMSSM. As the official journal of that society — and of Australasia’s ACSEP and Canada’s CASEM–we take a special interest in the research that emerges from these pre-eminent organizations.

And so it was a natural to reach out to Dr. Kliethermes to pick her brain on what we know — and perhaps, more importantly, what we don’t know — about the phenomenon of early youth sport specialization, rather recently identified as a significant public health problem in western societies.

Between her demanding academic schedule, her running, and her other outdoor escapades (glacier exploring it seems), she can be a difficult person to track down.  But also one who is unfailingly generous, humorous, and so very thoughtful and insightful in her interview style.

We know you will enjoy this podcast and will find the associated publication very informative.  So, take a listen and a read. You’re bound to learn a lot from Dr. Kliethermes and the AMSSM.

 

Disparities in sports medicine care — the pediatric ACL

MRI Sagittal view of left knee in a pediatric patient with an ACL tear

As 2020 winds down I want to bring to the attention of the blog readers a particularly important study published in our last edition of the year.  In our November 2020 issue you will find:  How do race and insurance status affect the care of pediatric anterior cruciate ligament injuries?

The group of authors hails from Children’s Hospital of Philadelphia (CHOP), which routinely vies for the top spot as best pediatric hospital in the U.S. 

Physicians from my home institution of Nationwide Children’s Hospital take a knee to protest racism June 2020

In a year like no other, 2020 saw the news dominated not just by the novel COVID pandemic but a pandemic much much older and more persistent: structural racism.  Around the world, sparked by incidents in the US in late May 2020, there was a passionate outcry from all segments of society, including the medical community, about this insidious problem.

The issues that are being discussed with renewed vigor are old, but the energy and insight surrounding this current moment feel anything but. Read more of this post

The AMSSM Position Statement on Conducting the PPE During the SARS-CoV-2 Pandemic

Dr. Alex B. Diamond, co-author of the recent AMSSM guidance statement on administering the PPE during the COVID pandemic

If you’re like us, we are ready to turn the page on 2020!

Literally and figuratively in CJSM’s case.

We’ve decided to push out the January 2021 issue early to get a start on the New Year!  And we’ve got our first podcast of the, ahem, ‘New Year’ to go along with it.

There are many submissions in this edition to highlight, but today I wanted to bring to the attention of the blog readers and podcast listeners one in particular.

CJSM’s partner society, the American Medical Society for Sports Medicine (AMSSM) convened a writing group early in 2020 to give guidance to clinicians in conducting the pre-participation examination (PPE) during the SARS-Cov-2 pandemic.  The result is a manuscript entitled, “Interim Guidance on the Preparticipation Physical Examination for Athletes During the SARS-CoV-2 Pandemic.”

The pandemic has touched all aspects of our field, and the PPE poses some new challenges that clinicians must address while the SARS virus holds sway.

Co-chair of the AMSSM committee and co-author of the AMSSM statement, Alex B. Diamond, D.O., M.P.H. is our guest on the first podcast of the new year.  The other co-chair was Dusty Narducci, M.D. Drs. Diamond and Narducci headed an illustrious team of authors, many whose names will be recognizable to those in the world of sports medicine (special shout out to two of our CJSM editors on the panel: Dr. William Roberts and Dr. Jason Zaremski).

Dr. Diamond is an Associate Professor in the Departments of Orthopaedics and Pediatrics at Vanderbilt University Medical Center, and among many other positions is also the team physician for several Nashville- area high schools, Vanderbilt University (NCAA D1) and the Nashville Predators of the NHL.

In our conversation we do a deep dive on conducting the PPE during the pandemic.  We cover issues such as venue (medical home vs. mass event), the risk of myocarditis in infected individuals, and the potential barriers to sport access created by the PPE.

Go to the statement, which is now freely available in our January 2021 issue. And go to iTunes to check out this episode and subscribe to all of our podcasts, or go to the journal’s main website to access the podcast and other CJSM media.

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