BJSM Podcast

Aseem Malhotra on the impact of diet on heart disease #Don’tFearTheFat

Dr Aseem Malhotra is a Consultant Interventional Cardiologist who has been the central catalyst in igniting the debate around the harms of excess sugar consumption in the United Kingdom. He has achieved this via writing commentaries in the BMJ, appearances on majors new channels including BBC, Sky News, ITV & Channel 4 and the regular columns he writes for the Guardian Newspaper about heart disease and other health topics –
http://www.theguardian.com/profile/aseem-malhotra.
He is the Science Director of the campaign group “Action On Sugar” and has been appointed as Consultant Clinical Associate tot the Academy of Medical Royal Colleges. Aseem was recently named in the London evening standard's top 10 "super smart set" in their 1000 most influential list. He has also made the Health Service Journal's top 50 BME outstanding contribution to health care list for the past two years in succession. 
Aseem has been arguably the most influential secondary care doctor in the UK on issues that effect population health. Thanks to his work it has now become government policy that AEDs will be introduced into all new schools. He is a keynote speaker at the Low Carb High Fat Summit in Cape Town between 19-22 February 2015.
In this podcast, Liam West poses the questions that see Aseem take us through the evidence behind the effect of cholesterol, saturated fat and sugar on heart disease.
Links to articles discussed in the podcast:
Lancet burden of global diseases report
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60460-8/abstract
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61682-2/abstract
NEJM – High fat Mediterranean diet versus low fat Mediterranean diet – impact on heart disease
http://www.nejm.org/doi/full/10.1056/NEJMoa1200303?viewType=Print&viewClass=Print&activeTab=comments&page=3
EPIC Interact Study
http://www.inter-act.eu/publications/publications---scientific-journals.html
BMJ Article - Saturated Fat 2013
http://www.bmj.com/content/347/bmj.f6340
Sanja Basu & Robert Lustig – sugar consumption and availability worldwide
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0057873
Nutritional BMJ publications 12/2/15 – sugar industry bias
http://www.bmj.com/company/wp-content/uploads/2015/02/sugar-invest.pdf
http://www.bmj.com/content/350/bmj.h780
http://www.bmj.com/content/350/bmj.h231
http://www.bmj.com/content/350/bmj.h215
http://www.bmj.com/content/350/bmj.h219
http://www.bmj.com/content/350/bmj.h220
Twitter handles:
@BJSM_BMJ
@DrAseemMalhotra
Low Carb High Fat Hashtag - #LCHF

Exercise interventions to prevent sports injuries – what you need to know

Dr Jeppe Bo Lauersen, currently working as a medical doctor in Copenhagen, investigated exercise intervention and its effects during a pre-graduate scholarship year at the Institute of Sport Science in Copenhagen with co-authors Ditte Bertelsen and Lars Bo Andersen. Prof Andersen, who is the head of the Centre for Research in Childhood Health at the University of Southern Denmark and a professor the Norwegian School of Sport Sciences, joins him on this podcast. They discuss their systematic review and meta-analysis of randomized control trials investigating exercise interventions for sports injuries.
In this podcast they share with us their interesting results, why some of the findings surprised them, and what conclusions we could take away from their work. Prof Andersen also shares some thoughts on the statistics and methods surrounding systematic reviews.
With exercise and its effect on health receiving much attention in the wide stream media currently, the authors discuss the effectiveness of exercise interventions, and what we should focus on when considering treatment of sports injuries.
Find their article here: http://bjsm.bmj.com/content/48/11/871.full

Mid-clavicular fracture: Open surgery or collar and cuff? Prof Bob McCormack (Olympic physician)

Clavicle fractures are common in contact sports as well as cycling trauma. Canada’s Olympic Team Chief Medical Officer shares dramatic results from a large RCT which has been a game changer.
Thanks to the Canadian Academy of Sports and Exercise Medicine (CASEM) for permission to steal this content from the CASEM Annual Meeting.
Enjoy this second of Bob McCormack’s three BJSM podcasts.
The first was on first time shoulder dislocation: http://goo.gl/3rvsLC
The third will cover AC joint separation.

Dr Rien Heijboer on cam lesions of the hip in athletes

Dr MP (Rien) Heijboer, orthopedic surgeon, works at the Dept at Orthopedic at the Erasamus Medical Centre in Rotterdam. He has extensive experience with sports-related injuries and has worked for more than 30 years as medical adviser of football club Feijenoord in Rotterdam.
He is a member of the medical staff of the Dutch National Soccer Team and visited the world soccer championships in Brasil in 2014, which he describes as a "life-time experience"!
He is president of the Dutch Orthopedic Society (NOV). Their annual congress will be held on February 5th and 6th 2015 in Maastricht: http://goo.gl/gzx2BS.
He has a great interest in sports-related injuries and today Rien discusses the latest research findings on cam and hip impingement in soccer players.
Further reading
A cam deformity is gradually acquired during skeletal maturation in adolescent and young male soccer players: a prospective study with minimum 2-year follow-up:
http://ajs.sagepub.com/content/42/4/798.abstract
Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study (CHECK):
http://www.oarsijournal.com/article/S1063-4584(13)00873-X/pdf
Cam impingement causes osteoarthritis of the hip: a nationwide prospective cohort study(CHECK): http://ard.bmj.com/content/72/6/918.abstract
The development of Cam-type deformity in adolescent and young male soccer players:
http://ajs.sagepub.com/content/40/5/1099.abstract
Clinical Graphics: https://www.clinicalgraphics.com/en/professionals/supporters/

Prof Tim Noakes: Time to revisit food choices, the Real Meal Revolution and #LCHF Summit for Health

“There is no essential human need for any carbohydrate” is just one of Professor Timothy Noakes’ quotes in this provocative chat. He explains insulin resistance, distinguishes between elite athletes and the general population, and provides examples of athletes who were likely insulin-resistant. He shares practical diet tips. BJSM asks whether diets high in protein and fat increase risk of bowel cancer or heart disease.
Tim explains the surprising catalyst for Cape Town hosting the world’s first Low Carb High Fat Health Summit (February 19 to 22, 2015). There you can meet Gary Taubes (Good Calories Bad Calories), Nina Teicholz (Big Fat Surprise) and a diverse range of experts who draw similar conclusions about healthy eating. The podcast closes with BJSM challenging Tim about changing his mind – doing ‘U-turns’ – how can a Professor think different things on different days?

Shoulder dislocation: to operate or rehabilitate? Prof Bob McCormack (Olympic physician)

Shoulder dislocation is common in sports, and management for the active athlete who dislocates for the first time remains controversial. Canada’s Olympic Medical Committee Medical Director, Prof Bob McCormack, explains the ways to assess patients to help decide whether to trial rehabilitation first or to opt for reconstruction.
Bob has vast experience as an Olympic team doctor (beginning with Sydney) and as a team physician in the Canadian Football League and Major League Soccer.
This is the first of 3 podcasts; he discusses management of AC joint separation and clavicle fracture in the others. BJSM welcomes the Canadian Academy of Sport & Exercise Medicine (CASEM) as one of 17 member societies (Full access to all content).

Training tomorrow’s doctors, in exercise medicine, for tomorrow’s patients

With Ann Gates and Ian Ritchie (@ExerciseWorks and Royal College of Surgeons of Edinburgh, respectively).
The ebullient Ann Gates, physical activity champion and social media phenomenon, explains that the campaign to train physicians to prescribe exercise is not squarely in the medical curriculum. In this joint podcast with Mr Ian Ritchie, we learn that surgeons are also taking up the cudgel to encourage physical activity before surgery, in hospital, and after surgery. Surgeons themselves need to be role models – to undertake 150 minutes of physical activity per week. Listen to the practical suggestions, share the free Nottingham University Medical School learning module at your institution.
See Ann Gates’ full editorial at http://bjsm.bmj.com/content/early/2015/01/01/bjsports-2014-094442.extract
The BJSM special issue on Physical Activity (2015) is issue #4 (Online first from January 30th, 2015)

Using ultrasound in sports medicine - office, sideline - wide range of options (via @TheAMSSM)

Drs Jon Finnoff and John DiFiori on sports ultrasound.
For several years, primary care sports medicine doctors have been mastering musculoskeletal ultrasound. With new technology comes a sharp learning curve and as the field matures, we begin to realise the full utility of point of care ultrasound. As sports medicine practitioners, we are now understanding that ultrasound has applications outside of the musculoskeletal system that may be advantageous for our practices. A couple of examples of this include FAST exam to look at abdominal trauma and limited echocardiography in pre-participation examination.
This podcast highlights 2 articles that will be published in the AMSSM themed edition of BJSM in February, 2015. One on a new sports ultrasound curriculum for sports medicine fellowships and the other on a position paper on US- guided interventional procedures. Dr Ken Mautner discusses these articles with the chair of the AMSSM MSK US Task force, Dr Jon Finnoff, as well as with the immediate past president of AMSSM, Dr John Difiori. They will shed much more light on the transition to this new term “Sports Ultrasound” and how it may impact your practice. They will also discuss some aspects of their interventional position paper on MSK US which is timely as there is continued downward trends in reimbursement for interventional US.
See also:
American Medical Society for Sports Medicine (AMSSM) position statement: interventional musculoskeletal ultrasound in sports medicine:
http://bjsm.bmj.com/content/early/2014/10/19/bjsports-2014-094219.full
American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships:
http://bjsm.bmj.com/content/early/2014/10/31/bjsports-2014-094220.full

Eccentric hamstring exercises – they work in practice but not in theory?

Dr David Opar joins us for this BJSM podcast. David is a lecturer at the Australian Catholic University in Melbourne and one of the emerging voices in the field of hamstring strain injuries, having done work on the possible mechanism of injury as well as prospective studies aimed at better understanding eccentric strength as a risk factor for these injuries.
His work also investigates the Nordic Hamstring Device, developed by the Queensland University of Technology Hamstring Group, looking into the potential of this device in prevention, treatment and rehabilitation of hamstring injuries.
Nicol van Dyk, a physiotherapist in the Rehabilitation Department at Aspetar Sports Medicine & Orthopaedic Hospital in Qatar, leads the discussion around nordic hamstring exercises, the role of eccentric strength in hamstring strain injuries and the seeing the big picture in prevention and rehabilitation.
With hamstring strain injuries continuing to receive much attention in the literature and mainstream media, David Opar elucidates some significant features of this common injury.

Cerebral palsy football

Cerebral Palsy (CP) Football in the UK gives players the opportunity to develop individual skills within a team environment, encased in an impairment competitive structure. The football programme contributes to the development of the England Cerebral Palsy Regional and National Squads, through talent identification with the goal to provide player performance pathway for elite performers, and also to provide participation opportunities for players of all abilities.
Dr Osman Ahmed (@osmanhahmed) has a PhD in concussion & social media where his research was focused on the use of Social Networking Sites (specifically Facebook) in assisting the recovery from sports concussion. Since 2003 he has been involved with providing physiotherapy services to a range of disability football teams for the Football Association including CP, Learning Disability, Blind, Partially sighted and Amputee squads.
Jordan Raynes (@jraynes32) has been involved with England CP Football team for many years now as a goalkeeper and has travelled with the squad to various competitions around the globe (including the Paralympic Games in Beijing in 2008).
To discuss CP football and the medical issues involved with the sport with Osman and Jordan is Dr Liam West (@Liam_West). Liam is a Senior Associate Editor of the BJSM and a junior doctor in Oxford, UK. He also runs the “Undergraduate Perspective on SEM” blog series for BJSM, building on his passion for increasing awareness and opportunities in SEM for undergraduates.
See also:
http://www.thefa.com/my-football/player/disability-football/play
http://www.thefa.com/news/england/development/2014/mar/cps-world-cup-at-sgp-200314
http://www.bbc.co.uk/sport/0/get-inspired/26545892
Enhancing performance and sport injury prevention in disability sport: moving forwards in the field of football
http://goo.gl/l8sFs2