September — the New Issue

Has summer already gone?

The colors that are starting to highlight the leaves. and the football seasons (both soccer and gridiron) that are at full throttle, are two signals that, indeed, fall is nearly here.

And while the actual equinox does not occur for another week, we have the September CJSM — just published — to help you ease your way through this seasonal transition.

We publish six times a year, and these bimonthly events are always exciting.  A publication represents months, even years, of planning. For authors who are at last seeing their studies in print, it is especially gratifying.  The studies have been published ‘on-line first’ and listed on PubMed for months; but it’s still a wonderful thing to find your work within the glossy covers of the journal.

I’m one of those authors this month — I authored a Case Report on the most benign of clinical issues (bilateral knee pain in a runner), that took unexpected twists and turns, leading me to work up a young woman for a rare neuromuscular disorder.   As always, we have several interesting Case Reports, including one on premature physeal closure in the foot in a ballet dancer en pointe (that’s ‘not supposed to happen’!)

Dr. Gian Corrado, lead author of a study looking at screening echocardiography

The Original Research studies that are leading the charge this month are both potentially ‘game changers’ in important and controversial areas of sports medicine. They both are also currently free.The first looks at the role that point-of-care echocardiography may play in the screening of young athletes for hypertrophic cardiomyopathy.  This work comes from Boston Children’s Hospital and Northeastern University, and is headed by a colleague who is someone I hold in great esteem:  Gianmichel Corrado.

The second study looks at the efficacy of radial extracorporeal shock wave therapy (rESWT) in the treatment of chronic distal biceps tendinopathy, a condition which, like many tendinous injuries, can be frustratingly difficult to treat, most especially in middle-aged weekend warriors (like me).  The investigator group was comprised of people from Europe and the U.S. They used a case-control study design with 12 month followup to demonstrate that this modality can be both safe and effective in middle-aged subjects (ages 30 – 64).

There is much, much more to be found within the covers of this new issue. Take a moment right now to click on the link and see what’s in store.

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Echocardiography as a screen to prevent SCD in athletes — 5 Questions with CJSM

 

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Dr. Gian Corrado performing screening cardiac ultrasound

For our first “5 Questions with CJSM” of 2017, we have a special guest:  Dr. Gianmichel Corrado, of Boston Children’s Hospital and Northeastern University.

Dr. Gian Corrado  is a doubly special guest for me: he is the lead author of a ‘published-ahead-of-print’ CJSM study and is someone who trained me in sports medicine at Boston Children’s Hospital.

I have fond memories of working alongside him, the head team physician for Northeastern University in Boston, as we cared for hockey and football athletes.  And I remember the work he was just beginning to do in his now-blossoming area of research.

The new study reports the findings of a novel ‘take’ on a controversial aspect of sports medicine: how might we screen for underlying disorders that predispose our athletes to sudden cardiac death (SCD)?

By the way, don’t let Dr. Gian Corrado’s name fool you — this is not that Dr. Corrado, (Domenico Corrado), who also has published on screening for SCD; but both Drs. Corrado share a similar concern: the primary prevention of this catastrophic event.

Dr. Gian Corrado’s approach is to use ‘screening echocardiography in front-line providers,’ and his findings can be found here:  ‘Early Screening for Cardiovascular Abnormalities with Pre-Participation Echocardiography:  Feasibility Study.’

Dr. Corrado has this to say about his important work:

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1. CJSM: What was the principal outcome measure you were looking at in this study? What were the secondary outcome measures?

GC: Central in the debate as to how to best identify athletes at risk for sudden death (SD) is cost-effectiveness.  The American Heart Association continues to recommend a history and physical (H&P) as the sole method for screening young athletes for the cardiac conditions that can cause SD.  The H&P has been shown to be a poor test to apply to the above dilemma as it misses athletes whom have potentially deadly cardiac conditions and falsely identifies those that do not.  Many feel that, given this reality, an electrocardiogram (ECG) screening program should be implemented.  This approach has been shown to have significant limitations as it too yields high false positive rates.  The Northeastern Group has suggested and demonstrated that with advances in portable ultrasound frontline providers (FLP) can obtain limited echocardiographic images pertinent to the structural conditions that dominate in culpability with SD. Read more of this post

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