1
|
Luszawski CA, Plourde V, Sick SR, Galarneau JM, Eliason PH, Brooks BL, Mrazik M, Debert CT, Lebrun C, Babul S, Hagel BE, Dukelow SP, Schneider KJ, Emery CA, Yeates KO. Psychosocial Factors Associated With Time to Recovery After Concussion in Adolescent Ice Hockey Players. Clin J Sport Med 2024; 34:256-265. [PMID: 37707392 DOI: 10.1097/jsm.0000000000001187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/06/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To investigate the association between psychosocial factors and physician clearance to return to play (RTP) in youth ice hockey players after sport-related concussion. DESIGN Prospective cohort study, Safe to Play (2013-2018). SETTING Youth hockey leagues in Alberta and British Columbia, Canada. PARTICIPANTS Three hundred fifty-three ice hockey players (aged 11-18 years) who sustained a total of 397 physician-diagnosed concussions. INDEPENDENT VARIABLES Psychosocial variables. MAIN OUTCOME MEASURES Players and parents completed psychosocial questionnaires preinjury. Players with a suspected concussion were referred for a study physician visit, during which they completed the Sport Concussion Assessment Tool (SCAT3/SCAT5) and single question ratings of distress and expectations of recovery. Time to recovery (TTR) was measured as days between concussion and physician clearance to RTP. Accelerated failure time models estimated the association of psychosocial factors with TTR, summarized with time ratios (TRs). Covariates included age, sex, body checking policy, days from concussion to the initial physician visit, and symptom severity at the initial physician visit. RESULTS Self-report of increased peer-related problems on the Strengths and Difficulties Questionnaire (TR, 1.10 [95% CI, 1.02-1.19]), higher ratings of distress about concussion outcomes by participants (TR, 1.06 [95% CI, 1.01-1.11]) and parents (TR, 1.05 [95% CI, 1.01-1.09]), and higher parent ratings of distress about their child's well-being at the time of injury (TR, 1.06 [95% CI, 1.02-1.09]) were associated with longer recovery. CONCLUSIONS Greater pre-existing peer-related problems and acute distress about concussion outcomes and youth well-being predicted longer TTR. Treatment targeting these psychosocial factors after concussion may promote recovery.
Collapse
Affiliation(s)
- Caroline A Luszawski
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Vickie Plourde
- School of Psychology, Université de Moncton, Moncton, New Brunswick, Canada
- Centre de Formation médicale du Nouveau-Brunswick, Université de Sherbrooke, Sherbrooke, New Brunswick, Canada
- Faculté Saint-Jean, University of Alberta, Edmonton, Alberta, Canada
| | - Stacy R Sick
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Michel Galarneau
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Paul H Eliason
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Brian L Brooks
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Alberta Children's Hospital, Neurosciences Program, Calgary, Alberta, Canada
- Departments of Pediatrics and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Martin Mrazik
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Chantel T Debert
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Constance Lebrun
- Glen Sather Sports Medicine Clinic, Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Shelina Babul
- Department of Pediatrics, Faculty of Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brent E Hagel
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; and
| | - Kathryn J Schneider
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A Emery
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
2
|
Gibson ES, Eliason PH, West SW, Black AM, Lebrun C, Emery CA, Pasanen K. Shoulder Check: Investigating Shoulder Injury Rates, Types, Severity, Mechanisms, and Risk Factors in Canadian Youth Ice Hockey. Clin J Sport Med 2024; 34:121-126. [PMID: 37389460 DOI: 10.1097/jsm.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/19/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE To describe shoulder-related injury rates (IRs), types, severity, mechanisms, and risk factors in youth ice hockey players during games and practices. DESIGN Secondary analysis of data from a 5-year prospective cohort study, Safe-to-Play (2013-2018). SETTING Canadian youth ice hockey. PARTICIPANTS Overall, 6584 player-seasons (representing 4417 individual players) participated. During this period, 118 shoulder-related games and 12 practice injuries were reported. ASSESSMENT OF RISK FACTORS An exploratory multivariable mixed-effects Poisson regression model examined the risk factors of body checking policy, weight, biological sex, history of injury in the past 12 months, and level of play. MAIN OUTCOME MEASURES Injury surveillance data were collected from 2013 to 2018. Injury rates with 95% confidence interval (CI) were estimated using Poisson regression. RESULTS The shoulder IR was 0.35 injuries/1000 game-hours (95% CI, 0.24-0.49). Two-thirds of game injuries (n = 80, 70%) resulted in >8 days of time-loss, and more than one-third (n = 44, 39%) resulted in >28 days of time-loss. An 83% lower rate of shoulder injury was associated with policy prohibiting body checking compared with leagues allowing body checking (incidence rate ratio [IRR], 0.17; 95% CI, 0.09-0.33). A higher shoulder IR was observed for those who reported any injury in the last 12-months compared with those with no history (IRR, 2.00; 95% CI, 1.33-3.01). CONCLUSIONS Most shoulder injuries resulted in more than 1 week of time-loss. Risk factors for shoulder injury included participation in a body-checking league and recent history of injury. Further study of prevention strategies specific to the shoulder may merit further consideration in ice hockey.
Collapse
Affiliation(s)
- Eric S Gibson
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Integrative Neuromuscular Sport Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Paul H Eliason
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Stephen W West
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department for Health, Centre for Health, Illness, and Injury Prevention in Sport, University of Bath, Bath, United Kingdom
- UK Collaborating Centre on Injury and Illness Prevention in Sport, Bath, United Kingdom
| | - Amanda M Black
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Constance Lebrun
- Department of Family Medicine, Faculty of Medicine & Dentistry, and Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, AB, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; and
| | - Kati Pasanen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Integrative Neuromuscular Sport Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; and
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| |
Collapse
|
3
|
Eliason P, Galarneau JM, Shill I, Kolstad A, Babul S, Mrazik M, Lebrun C, Dukelow S, Schneider K, Hagel B, Emery C. Factors Associated With Concussion Rates in Youth Ice Hockey Players: Data From the Largest Longitudinal Cohort Study in Canadian Youth Ice Hockey. Clin J Sport Med 2023; 33:497-504. [PMID: 37432327 DOI: 10.1097/jsm.0000000000001177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To examine factors associated with rates of game and practice-related concussion in youth ice hockey. DESIGN Five-year prospective cohort (Safe2Play). SETTING Community arenas (2013-2018). PARTICIPANTS Four thousand eighteen male and 405 female ice hockey players (6584 player-seasons) participating in Under-13 (ages 11-12), Under-15 (ages 13-14), and Under-18 (ages 15-17) age groups. ASSESSMENT OF RISK FACTORS Bodychecking policy, age group, year of play, level of play, previous injury in the previous year, lifetime concussion history, sex, player weight, and playing position. MAIN OUTCOME MEASUREMENTS All game-related concussions were identified using validated injury surveillance methodology. Players with a suspected concussion were referred to a study sport medicine physician for diagnosis and management. Multilevel Poisson regression analysis including multiple imputation of missing covariates estimated incidence rate ratios (IRRs). MAIN RESULTS A total of 554 game and 63 practice-related concussions were sustained over the 5 years. Female players (IRR Female/Male = 1.79; 95% CI: 1.26-2.53), playing in lower levels of play (IRR = 1.40; 95% CI: 1.10-1.77), and those with a previous injury (IRR = 1.46; 95% CI: 1.13, 1.88) or lifetime concussion history (IRR = 1.64; 95% CI: 1.34-2.00) had higher rates of game-related concussion. Policy disallowing bodychecking in games (IRR = 0.54; 95% CI: 0.40-0.72) and being a goaltender (IRR Goaltenders/Forwards = 0.57; 95% CI: 0.38-0.87) were protective against game-related concussion. Female sex was also associated with a higher practice-related concussion rate (IRR Female/Male = 2.63; 95% CI: 1.24-5.59). CONCLUSIONS In the largest Canadian youth ice hockey longitudinal cohort to date, female players (despite policy disallowing bodychecking), players participating in lower levels of play, and those with an injury or concussion history had higher rates of concussion. Goalies and players in leagues that disallowed bodychecking had lower rates. Policy prohibiting bodychecking remains an effective concussion prevention strategy in youth ice hockey.
Collapse
Affiliation(s)
- Paul Eliason
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jean-Michel Galarneau
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Isla Shill
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Ash Kolstad
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Shelina Babul
- British Columbia Injury Research and Prevention Unit, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Martin Mrazik
- Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Constance Lebrun
- Family Medicine, Faculty of Medicine and Dentistry and Glen Sather Sport Medicine Clinic, University of Alberta, Edmonton, AB, Canada
| | - Sean Dukelow
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences and Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kathryn Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences and Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Brent Hagel
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; and
- Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Carolyn Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; and
- Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
4
|
Eliason P, Hagel BE, Palacios-Derflingher L, Warriyar K V V, Bonfield S, Black AM, Babul S, Mrazik M, Lebrun C, Emery C. No association found between body checking experience and injury or concussion rates in adolescent ice hockey players. Br J Sports Med 2022; 56:1337-1344. [PMID: 35168958 DOI: 10.1136/bjsports-2021-104691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To compare rates of injury and concussion among U-15 (ages 13-14 years) ice hockey players playing in leagues allowing body checking, but who have a varying number of years of body checking experience. METHODS This 5-year longitudinal cohort included U-15 ice hockey players playing in leagues where policy allowed body checking. Years of body checking experience were classified based on national/local body checking policy. All ice hockey game-related injuries were identified using a validated injury surveillance methodology. Players with a suspected concussion were referred to a study sport medicine physician. Multiple multilevel Poisson regression analysis was performed, adjusting for important covariates and a random effect at a team level (offset by game exposure hours), to estimate injury and concussion incidence rate ratios (IRRs). RESULTS In total, 1647 players participated, contributing 1842 player-seasons (195 players participating in two seasons). Relative to no body checking experience, no significant differences were found in the adjusted IRRs for game-related injury for players with 1 year (IRR=1.06; 95% CI: 0.77 to 1.45) or 2+ years (IRR=1.16; 95% CI: 0.74 to 1.84) body checking experience. Similarly, no differences were found in the rates of concussion for players with 1 year (IRR=0.92; 95% CI: 0.59 to 1.42) or 2+ years (IRR=0.69; 95% CI: 0.38 to 1.25) body checking experience. CONCLUSIONS Among ice hockey players aged 13-14 years participating in leagues permitting body checking, the adjusted rates of all injury and concussion were not significantly different between those that had body checking experience and those that did not. Based on these findings, no association was found between body checking experience and rates of injury or concussion specifically in adolescent ice hockey.
Collapse
Affiliation(s)
- Paul Eliason
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Brent E Hagel
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Luz Palacios-Derflingher
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Australian Health Services Research Institute (AHSRI), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia
| | - Vineetha Warriyar K V
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
| | - Stephan Bonfield
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
| | - Amanda Marie Black
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Shelina Babul
- British Columbia Injury Research and Prevention Unit, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Mrazik
- Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
| | - Constance Lebrun
- Family Medicine, Faculty of Medicine and Dentistry and Glen Sather Sport Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada
| | - Carolyn Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
5
|
Eliason PH, Hagel BE, Palacios-Derflingher L, Warriyar V, Bonfield S, Black AM, Mrazik M, Lebrun C, Emery CA. Bodychecking experience and rates of injury among ice hockey players aged 15-17 years. CMAJ 2022; 194:E834-E842. [PMID: 35725006 PMCID: PMC9261946 DOI: 10.1503/cmaj.211718] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although high rates of injury occur in youth ice hockey, disagreements exist about the risks and benefits of permitting bodychecking. We sought to evaluate associations between experience with bodychecking and rates of injury and concussion among ice hockey players aged 15-17 years. METHODS We obtained data from a prospective cohort study of ice hockey players aged 15-17 years in Alberta who played in leagues that permitted bodychecking. We collected data over 3 seasons of play (2015/16-2017/18). We compared players based on experience with bodychecking (≤ 2 v. ≥ 3 yr), estimated using local and national bodychecking policy and region of play. We used validated methodology of ice hockey injury surveillance to identify all injuries related to ice hockey games and defined concussions according to the Consensus Statement on Concussion in Sport. RESULTS We included 941 players who contributed to 1168 player-seasons, with 205 players participating in more than 1 season. Compared with players with 2 years or less of bodychecking experience, those with 3 or more years of experience had higher rates of all injury (adjusted incidence rate ratio [IRR] 2.55, 95% confidence interval [CI] 1.57-4.14), injury with more than 7 days of time loss (adjusted IRR 2.65, 95% CI 1.50-4.68) and concussion (adjusted IRR 2.69, 95% CI 1.34-5.42). INTERPRETATION Among ice hockey players aged 15-17 years who participated in leagues permitting bodychecking, more experience with bodychecking did not protect against injury. This provides further support for removing bodychecking from youth ice hockey.
Collapse
Affiliation(s)
- Paul H Eliason
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta.
| | - Brent E Hagel
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| | - Luz Palacios-Derflingher
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| | - Vineetha Warriyar
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| | - Stephan Bonfield
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| | - Amanda M Black
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| | - Martin Mrazik
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| | - Constance Lebrun
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre (Eliason, Hagel, Palacios-Derflingher, Warriyar KV, Bonfield, Black, Emery), Faculty of Kinesiology, University of Calgary; Integrated Concussion Research Program (Eliason, Black), University of Calgary; Departments of Pediatrics and Community Health Sciences (Hagel, Emery), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Australian Health Services Research Institute (Palacios-Derflingher), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia; Faculty of Education (Mrazik), University of Alberta; Department of Family Medicine (Lebrun), Faculty of Medicine and Dentistry; Glen Sather Sport Medicine Clinic (Lebrun), University of Alberta, Edmonton, Alta
| |
Collapse
|
6
|
Emery CA, Eliason P, Warriyar V, Palacios-Derflingher L, Black AM, Krolikowski M, Spencer N, Sick S, Kozak S, Schneider KJ, Babul S, Mrazik M, Lebrun C, Goulet C, Macpherson A, Hagel BE. Body checking in non-elite adolescent ice hockey leagues: it is never too late for policy change aiming to protect the health of adolescents. Br J Sports Med 2022; 56:12-17. [PMID: 34016603 DOI: 10.1136/bjsports-2020-103757] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The objective of this study is to evaluate the effect of policy change disallowing body checking in adolescent ice hockey leagues (ages 15-17) on reducing rates of injury and concussion. METHODS This is a prospective cohort study. Players 15-17 years-old were recruited from teams in non-elite divisions of play (lower 40%-70% by division of play depending on year and city of play in leagues where policy permits or prohibit body checking in Alberta and British Columbia, Canada (2015-18). A validated injury surveillance methodology supported baseline, exposure-hours and injury data collection. Any player with a suspected concussion was referred to a study physician. Primary outcomes include game-related injuries, game-related injuries (>7 days time loss), game-related concussions and game-related concussions (>10 days time loss). RESULTS 44 teams (453 player-seasons) from non-body checking and 52 teams (674 player-seasons) from body checking leagues participated. In body checking leagues there were 213 injuries (69 concussions) and in non-body checking leagues 40 injuries (18 concussions) during games. Based on multiple multilevel mixed-effects Poisson regression analyses, policy prohibiting body checking was associated with a lower rate of injury (incidence rate ratio (IRR): 0.38 (95% CI 0.24 to 0.6)) and concussion (IRR: 0.49; 95% CI 0.26 to 0.89). This translates to an absolute rate reduction of 7.82 injuries/1000 game-hours (95% CI 2.74 to 12.9) and the prevention of 7326 injuries (95% CI 2570 to 12083) in Canada annually. CONCLUSIONS The rate of injury was 62% lower (concussion 51% lower) in leagues not permitting body checking in non-elite 15-17 years old leagues highlighting the potential public health impact of policy prohibiting body checking in older adolescent ice hockey players.
Collapse
Affiliation(s)
- Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul Eliason
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Vineetha Warriyar
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Luz Palacios-Derflingher
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Amanda Marie Black
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Maciek Krolikowski
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Nicole Spencer
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Stacy Sick
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Stacy Kozak
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Shelina Babul
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Injury Research & Prevention Unit, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Martin Mrazik
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Constance Lebrun
- Glen Sather Sports Medicine Clinic, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Claude Goulet
- Department of Physical Education, Laval University, Quebec City, Quebec, Canada
| | - Alison Macpherson
- School of Kinesiology & Health SCience, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Brent E Hagel
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
7
|
Michel M, Le Page E, Laplaud DA, Wardi R, Lebrun C, Zagnoli F, Wiertlewski S, Coustans M, Edan G, Chevreul K, Veillard D. Cost-utility of oral methylprednisolone in the treatment of multiple sclerosis relapses: Results from the COPOUSEP trial. Rev Neurol (Paris) 2021; 178:241-248. [PMID: 34598781 DOI: 10.1016/j.neurol.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Studies have shown that oral high-dose methylprednisolone (MP) is non-inferior to intravenous MP in treating multiple sclerosis relapses in terms of effectiveness and tolerance. In order to assist with resource allocation and decision-making, its cost-effectiveness must also be assessed. Our objective was to evaluate the cost-utility of per os high-dose MP as well as the cost-savings associated with implementing the strategy. METHODS A cost-utility analysis at 28 days was carried out using data from the French COPOUSEP multicenter, double-blind randomized controlled non-inferiority trial and the statutory health insurance reimbursement database. Costs were calculated using a societal perspective, including both direct and indirect costs. An incremental cost-effectiveness ratio was calculated and bootstrapping methods assessed the uncertainty surrounding the results. An alternative scenario analysis in which MP was administered at home was also carried out. A budgetary impact analysis was carried at five years. RESULTS In the conditions of the trial (hospitalized patients), there was no significant difference in utilities and costs at 28 days. The incremental cost-effectiveness ratio was €15,360 per quality-adjusted life-year gained. If multiple sclerosis relapses were treated at home, oral MP would be more effective, less costly and associated with annual savings up to 25 million euros for the French healthcare system. CONCLUSIONS Oral MP is cost-effective in the treatment of multiple sclerosis relapses and associated with major savings.
Collapse
Affiliation(s)
- M Michel
- AP-HP, URC Eco Ile-de-France, DRCI, Paris, France/Hôpital Robert Debré, Unité d'Epidémiologie Clinique, Paris, France; Université de Paris, ECEVE, Inserm, 75010 Paris, France; Inserm, ECEVE, U1123, Paris, France
| | - E Le Page
- Clinical Neuroscience Centre, CIC-P 1414 Inserm, Rennes University Hospital, Rennes, France
| | - D A Laplaud
- UMR1064, Inserm, and CIC015, Inserm, Nantes, France
| | - R Wardi
- Neurology Department, Saint Brieuc Hospital, Saint-Brieuc, France
| | - C Lebrun
- Neurology Department, Nice University Hospital, Nice, France
| | - F Zagnoli
- Neurology Department, Military Hospital, Brest, France
| | - S Wiertlewski
- Neurology Department, Nantes University Hospital, Nantes, France
| | - M Coustans
- Neurology Department, Quimper Hospital, Quimper, France
| | - G Edan
- Clinical Neuroscience Centre, CIC-P 1414 Inserm, Rennes University Hospital, Rennes, France
| | - K Chevreul
- AP-HP, URC Eco Ile-de-France, DRCI, Paris, France/Hôpital Robert Debré, Unité d'Epidémiologie Clinique, Paris, France; Université de Paris, ECEVE, Inserm, 75010 Paris, France; Inserm, ECEVE, U1123, Paris, France
| | - D Veillard
- Epidemiology and Public Health Department, Rennes University Hospital, Rennes, France.
| | | | | |
Collapse
|
8
|
Emery CA, Warriyar Kv V, Black AM, Palacios-Derflingher L, Sick S, Debert C, Brooks BL, Yeates KO, Mrazik M, Lebrun C, Hagel BE, Dukelow S, Schneider KJ. Factors Associated With Clinical Recovery After Concussion in Youth Ice Hockey Players. Orthop J Sports Med 2021; 9:23259671211013370. [PMID: 34017881 PMCID: PMC8114271 DOI: 10.1177/23259671211013370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/24/2021] [Indexed: 11/15/2022] Open
Abstract
Background: The identification of factors associated with clinical recovery in youth after sports-related concussion could improve prognostication regarding return to play (RTP). Purpose: To assess factors associated with clinical recovery after concussion in youth ice hockey players. Study Design: Cohort study; Level of evidence, 2. Methods: Participants were part of a larger longitudinal cohort study (the Safe to Play study; N = 3353). Included were 376 ice hockey players (age range, 11-17 years) from teams in Calgary and Edmonton, Canada, with 425 physician-diagnosed ice hockey–related concussions over 5 seasons (2013-2018). Any player with a suspected concussion was referred to a sports medicine physician for diagnosis, and a Sport Concussion Assessment Tool (SCAT) form was completed. Time to clinical recovery was based on time between concussion and physician clearance to RTP. Two accelerated failure time models were used to estimate days to RTP clearance: model 1 considered symptom severity according to the SCAT3/SCAT5 symptom evaluation score (range, 0-132 points), and model 2 considered responses to individual symptom evaluation items (eg, headache, neck pain, dizziness) of none/mild (0-2 points) versus moderate/severe (3-6 points). Other covariates were time to physician first visit (≤7 and >7 days), age group (11-12, 13-14, and 15-17 years), sex, league type (body checking and no body checking), tandem stance (modified Balance Error Scoring System result ≥4 errors out of 10), and number of previous concussions (0, 1, 2, and ≥3). Results: The complete case analysis (including players without missing covariates) included 329 players (366 diagnosed concussions). The median time to clinical recovery was 18 days. In model 1, longer time to first physician visit (>7 days) (time ratio [TR], 1.637 [95% confidence interval (CI), 1.331-1.996]) and greater symptom severity (TR, 1.016 [95% CI, 1.012-1.020]) were significant predictors of longer clinical recovery. In model 2, longer time to first physician visit (TR, 1.698 [95% CI, 1.399-2.062]), headache (moderate/severe) (TR, 1.319 [95% CI, 1.110-1.568]), and poorer tandem stance (TR, 1.249 [95% CI, 1.052-1.484]) were significant predictors of longer clinical recovery. Conclusion: Medical clearance to RTP was longer for players with >7 days to physician assessment, poorer tandem stance, greater symptom severity, and moderate/severe headache at first visit.
Collapse
Affiliation(s)
- Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vineetha Warriyar Kv
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Amanda M Black
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Luz Palacios-Derflingher
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stacy Sick
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Chantel Debert
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences and Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Brian L Brooks
- O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada.,Neurosciences Program, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Keith Owen Yeates
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences and Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada
| | - Martin Mrazik
- Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
| | - Constance Lebrun
- Family Medicine, Faculty of Medicine and Dentistry and Glen Sather Sport Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada
| | - Brent E Hagel
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sean Dukelow
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences and Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences and Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
9
|
Schneider KJ, Nettel-Aguirre A, Palacios-Derflingher L, Mrazik M, Brooks BL, Woollings K, Blake T, McKay C, Lebrun C, Barlow K, Taylor K, Lemke N, Meeuwisse WH, Emery CA. Concussion Burden, Recovery, and Risk Factors in Elite Youth Ice Hockey Players. Clin J Sport Med 2021; 31:70-77. [PMID: 30300143 DOI: 10.1097/jsm.0000000000000673] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine rates of concussion and more severe concussion (time loss of greater than 10 days) in elite 13- to 17-year-old ice hockey players. METHODS This is a prospective cohort study (Alberta, Canada). Bantam (13-14 years) and Midget (15-17 years) male and female elite (top 20% by division of play) youth ice hockey players participated in this study. Players completed a demographic and medical history questionnaire and clinical test battery at the beginning of the season. A previously validated injury surveillance system was used to document exposure hours and injury during one season of play (8 months). Players with a suspected ice hockey-related concussion were referred to the study sport medicine physicians for assessment. Time loss from hockey participation was documented on an injury report form. RESULTS Overall, 778 elite youth ice hockey players (659 males and 119 females; aged 13-17 years) participated in this study. In total, 143 concussions were reported. The concussion incidence rate (IR) was 17.60 concussions/100 players (95% CI, 15.09-20.44). The concussion IR was 1.31 concussions/1000 player-hours (95% CI, 1.09-1.57). Time loss of greater than 10 days was reported in 74% of cases (106/143), and 20% (n = 28) had time loss of greater than 30 days. CONCLUSIONS Concussion is a common injury in elite youth ice hockey players. In this study population, a large proportion of concussions (74%) resulted in a time loss of greater than 10 days, possibly reflecting more conservative management or longer recovery in youth athletes.
Collapse
Affiliation(s)
- Kathryn J Schneider
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Alberto Nettel-Aguirre
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Luz Palacios-Derflingher
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Martin Mrazik
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | - Brian L Brooks
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Neurosciences Program, Alberta Children's Hospital, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Kaikanani Woollings
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
| | - Tracy Blake
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Carly McKay
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Department for Health, University of Bath, Bath, Somerset, United Kingdom
| | - Constance Lebrun
- Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, AB, Canada
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada ; and
| | - Karen Barlow
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Medicine, Child Health Research Centre, University of Queensland, Queensland, Australia
| | - Kirsten Taylor
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
| | - Nicole Lemke
- Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, AB, Canada
| | - Willem H Meeuwisse
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Carolyn A Emery
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
10
|
Humphries D, Jaques R, Dijkstra HP, Asif I, Batt ME, Borjesson M, Ergen E, Geertsema C, Gojanovic B, Ionescu A, Janse van Rensburg DC, Lebrun C, Mohamed NA, Mountjoy M, Parikh T, Robinson D, Sallis R, Schwellnus M, Sheeran P. Delphi developed syllabus for the medical specialty of sport and exercise medicine: part 2. Br J Sports Med 2020; 55:81-83. [DOI: 10.1136/bjsports-2020-102102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 11/04/2022]
Abstract
Training in the medical specialty of sport and exercise medicine (SEM) is available in many, but not all countries. In 2015, an independent Delphi group, the International Syllabus in Sport and Exercise Medicine Group (ISSEMG), was formed to create a basic syllabus for this medical specialty. The group provided the first part of this syllabus, by identifying 11 domains and a total of 80 general learning areas for the specialty, in December 2017. The next step in this process, and the aim of this paper was to determine the specific learning areas for each of the 80 general learning areas. A group of 26 physicians with a range of primary medical specialty qualifications including, Sport and Exercise Medicine, Family Medicine, Internal Medicine, Cardiology, Rheumatology and Anaesthetics were invited to participate in a multiple round online Delphi study to develop specific learning areas for each of the previously published general learning areas. All invitees have extensive clinical experience in the broader sports medicine field, and in one or more components of sports medicine governance at national and/or international level. SEM, Family Medicine, Internal Medicine, Cardiology, Rheumatology and Anaesthetics were invited to participate in a multiple round online Delphi study to develop specific learning areas for each of the previously published general learning areas. All invitees have extensive clinical experience in the broader sports medicine field, and in one or more components of sports medicine governance at national and/or international level. The hierarchical syllabus developed by the ISSEMG provides a useful resource in the planning, development and delivery of specialist training programmes in the medical specialty of SEM.
Collapse
|
11
|
Pourcher V, Lebrun C, Vukusic S. Vaccinations et sclérose en plaques : recommandations de la Société francophone de la sclérose en plaques (SFSEP). Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Bigaut K, Lambert C, Kremer L, Lebrun C, Cohen M, Ciron J, Bourre B, Créange A, Kerschen P, Montcuquet A, Carra-Dalliere C, Ayrignac X, Labauge P, de Seze J, Collongues N. Atypical myelitis in patients with multiple sclerosis: Characterization and comparison with typical multiple sclerosis and neuromyelitis optica spectrum disorders. Mult Scler 2020; 27:232-238. [DOI: 10.1177/1352458520906995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Atypical myelitis in multiple sclerosis (MS) is characterized by extensive myelitis in the longitudinal (longitudinally extensive transverse myelitis) or axial plane (transverse myelitis). Objective: To characterize a cohort of MS patients with atypical myelitis. Methods: Atypical myelitis was extracted from the French and Luxembourg MS databases and compared to two cohorts of MS patients with typical myelitis and neuromyelitis optica spectrum disorders (NMOSDs) patients with myelitis. Results: We enrolled 28 MS patients with atypical myelitis, 68 MS patients with typical myelitis and 119 NMOSD patients with a first episode of myelitis. MS patients with atypical myelitis were characterized by a mean age of 34.0 (±10.7) years and 64.3% were women. In 82.1% of the patients, atypical myelitis was the first episode of MS. Mean Expanded Disability Status Scale (EDSS) scores at nadir and 3–6 months after onset were 4.1 ± 2.1 and 3.3 ± 2, respectively. Differences between groups revealed a predominance of cervicothoracic myelitis and a higher level of disability in NMOSD patients. Disability in MS patients with atypical myelitis was more severe than in the MS patients with typical myelitis; 28% had already converted to progressive MS within our mean follow-up of 39.6 (±30.4) months. Conclusion: Atypical myelitis may be the first presentation of MS and is associated with poorer prognosis.
Collapse
Affiliation(s)
- K Bigaut
- CRC-SEP, Neurologie, Hôpital de Hautepierre, Strasbourg, France
| | - C Lambert
- CRC-SEP, Neurologie, Hôpital de Hautepierre, Strasbourg, France
| | - L Kremer
- CRC-SEP, Neurologie, Hôpital de Hautepierre, Strasbourg, France
| | - C Lebrun
- CRC-SEP, Neurologie, Université Nice Côte d’Azur, CHU Pasteur 2, Nice, France
| | - M Cohen
- CRC-SEP, Neurologie, Université Nice Côte d’Azur, CHU Pasteur 2, Nice, France
| | - J Ciron
- CRC-SEP, Neurologie, CHU Toulouse, Toulouse, France
| | - B Bourre
- Service de Neurologie, CHU de Rouen, Rouen, France
| | - A Créange
- Service de Neurologie, CHU de Créteil, Paris, France
| | - P Kerschen
- Service de Neurologie, Centre Hospitalier de Luxembourg, Luxembourg
| | - A Montcuquet
- Service de Neurologie, CHU de Limoges, Limoges, France
| | | | - X Ayrignac
- CRC-SEP, Neurologie, CHU de Montpellier, Montpellier, France
| | - P Labauge
- CRC-SEP, Neurologie, CHU de Montpellier, Montpellier, France
| | - J de Seze
- CRC-SEP, Neurologie, Hôpital de Hautepierre, Strasbourg, France
| | - N Collongues
- CRC-SEP, Neurologie, Hôpital de Hautepierre, Strasbourg, France
| |
Collapse
|
13
|
Lebrun C, Gély-Nargeot MC, Rossignol A, Geny C, Bayard S. Effectiveness Of Cognitive Behavioral Therapy For Insomnia Comorbid To Parkinson's Disease: A Focus On Psychological And Daytime Functioning. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
14
|
Guillard F, Merens A, Dortet L, Janvier F, Lebrun C, Yin N, Grillon A, Amara M, Jaureguy F, Héry-Arnaud M. Évaluation de la prévalence de la résistance aux antibiotiques chez les entérobactéries isolées de prélèvements urinaires dans les services d’urgence de France. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
15
|
Lebrun C, Vukusic S, Abadie V, Achour C, Ader F, Alchaar H, Alkhedr A, Andreux F, Androdias G, Arjmand R, Audoin B, Audry D, Aufauvre D, Autreaux C, Ayrignac X, Bailbe M, Benazet M, Bensa C, Bensmail D, Berger E, Bernady P, Bertagna Y, Biotti D, Blanchard-Dauphin A, Bonenfant J, Bonnan M, Bonnemain B, Borgel F, Botelho-Nevers E, Boucly S, Bourre B, Boutière C, Branger P, Brassat D, Bresch S, Breuil V, Brochet B, Brugeilles H, Bugnon P, Cabre P, Camdessanché JP, Carra-Dalière C, Casez O, Chamouard JM, Chassande B, Chataignier P, Chbicheb M, Chenet A, Ciron J, Clavelou P, Cohen M, Colamarino R, Collongues N, Coman I, Corail PR, Courtois S, Coustans M, Creange A, Creisson E, Daluzeau N, Davenas C, De Seze J, Debouverie M, Depaz R, Derache N, Divio L, Douay X, Dulau C, Durand-Dubief F, Edan G, Elias Z, Fagniez O, Faucher M, Faucheux JM, Fournier M, Gagneux-Brunon A, Gaida P, Galli P, Gallien P, Gaudelus J, Gault D, Gayou A, Genevray M, Gentil A, Gere J, Gignoux L, Giroux M, Givron P, Gout O, Grimaud J, Guennoc AM, Hadhoum N, Hautecoeur P, Heinzlef O, Jaeger M, Jeannin S, Kremer L, Kwiatkowski A, Labauge P, Labeyrie C, Lachaud S, Laffont I, Lanctin-Garcia C, Lannoy J, Lanotte L, Laplaud D, Latombe D, Lauxerois M, Le Page E, Lebrun-Frenay C, Lejeune P, Lejoyeux P, Lemonnier B, Leray E, Loche CM, Louapre C, Lubetzki C, Maarouf A, Mada B, Magy L, Maillart E, Manchon E, Marignier R, Marque P, Mathey G, Maurousset A, Mekies C, Merienne M, Michel L, Milor AM, Moisset X, Montcuquet A, Moreau T, Morel N, Moussa M, Naudillon JP, Normand M, Olive P, Ouallet JC, Outteryck O, Pacault C, Papeix C, Patry I, Peaureaux D, Pelletier J, Pichon B, Pittion S, Planque E, Pouget MC, Pourcher V, Radot C, Robert I, Rocher F, Ruet A, Ruet A, Saint-Val C, Salle JY, Salmon A, Sartori E, Schaeffer S, Stankhof B, Taithe F, Thouvenot E, Tizon C, Tourbah A, Tourniaire P, Vaillant M, Vermersch P, Vidil S, Wahab A, Warter MH, Wiertlewski S, Wiplosz B, Wittwer B, Zaenker C, Zephir H. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society. Rev Neurol (Paris) 2019; 175:341-357. [DOI: 10.1016/j.neurol.2019.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 03/31/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
|
16
|
Margier M, Collet X, Le May C, Desmarchelier C, André F, Lebrun C, Defoort C, Bluteau A, Borel P, Lespine A, Reboul E. ABCB1 (P-glycoprotéine) contribue à la régulation de l’absorption et à l’efflux transintestinal de vitamine D. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
17
|
Lebrun C, Bertagna M, Bresch S, Cohen M. Digestive side-effects with teriflunomide: Thoughts on lactose. Rev Neurol (Paris) 2018; 174:722-725. [DOI: 10.1016/j.neurol.2017.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/25/2017] [Accepted: 11/20/2017] [Indexed: 12/21/2022]
|
18
|
Balloy G, Pelletier J, Suchet L, Lebrun C, Cohen M, Vermersch P, Zephir H, Duhin E, Gout O, Deschamps R, Le Page E, Edan G, Labauge P, Carra-Dallieres C, Rumbach L, Berger E, Lejeune P, Devos P, N'Kendjuo JB, Coustans M, Auffray-Calvier E, Daumas-Duport B, Michel L, Lefrere F, Laplaud DA, Brosset C, Derkinderen P, de Seze J, Wiertlewski S. Inaugural tumor-like multiple sclerosis: clinical presentation and medium-term outcome in 87 patients. J Neurol 2018; 265:2251-2259. [PMID: 30054790 DOI: 10.1007/s00415-018-8984-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Tumefactive demyelinating lesions of the central nervous system can be the initial presentation in various pathological entities [multiple sclerosis (the most common), Balo's concentric sclerosis, Schilder's disease and acute disseminated encephalomyelitis] with overlapping clinical presentation. The aim of our study was to better characterize these patients. METHODS Eighty-seven patients (62 women and 25 men) from different MS centers in France were studied retrospectively. Inclusion criteria were (1) a first clinical event (2) MRI showing one or more large demyelinating lesions (20 mm or more in diameter) with mass-like features. Patients with a previous demyelinating event (i.e. confirmed multiple sclerosis) were excluded. RESULTS Mean age at onset was 26 years. The most common initial symptoms (67% of the patients) were hemiparesis or hemiplegia. Aphasia, headache and cognitive disturbances (i.e. atypical symptoms for demyelinating diseases) were observed in 15, 18 and 15% of patients, respectively. The mean largest diameter of the tumefactive lesions was 26.9 mm, with gadolinium enhancement in 66 patients (81%). Twenty-one patients (24%) had a single tumefactive lesion. During follow-up (median time 5.7 years) 4 patients died, 70 patients improved or remained stable and 12 worsened. 86% of patients received initial corticosteroid treatment, and 73% received disease-modifying therapy subsequently. EDSS at the end of the follow-up was 2.4 ± 2.6 (mean ± SD). CONCLUSION This study provides further evidence that the clinical course of MS presenting with large focal tumor-like lesions does not differ from that of classical relapsing-remitting MS, once the noisy first relapsing occurred.
Collapse
Affiliation(s)
- G Balloy
- Neurology Department, University of Nantes Hospital, Nantes, France. .,Service de Neurologie, Hopital Laennec, Boulevard Jacques Monod, 44800, Saint Herblain, France.
| | - J Pelletier
- Neurosciences Unit, Neurology Department, Timone Hospital, Aix Marseille University, APHM, Marseille, France
| | - L Suchet
- Neurosciences Unit, Neurology Department, Timone Hospital, Aix Marseille University, APHM, Marseille, France
| | - C Lebrun
- University of Nice Hospital, Nice, France
| | - M Cohen
- University of Nice Hospital, Nice, France
| | | | - H Zephir
- University of Lille Hospital, Lille, France
| | - E Duhin
- University of Lille Hospital, Lille, France
| | - O Gout
- Rothschild Foundation, Paris, France
| | | | - E Le Page
- University of Rennes Hospital, Rennes, France
| | - G Edan
- University of Rennes Hospital, Rennes, France
| | - P Labauge
- University of Montpellier Hospital, Montpellier, France
| | | | - L Rumbach
- University Besançon Hospital, Besançon, France
| | - E Berger
- University Besançon Hospital, Besançon, France
| | - P Lejeune
- La Roche sur Yon Hospital, La Roche-sur-Yon, France
| | - P Devos
- Boulogne-sur-Mer Hospital, Boulogne-sur-Mer, France
| | | | | | | | - B Daumas-Duport
- Radiology Department, University of Nantes Hospital, Nantes, France
| | - L Michel
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - F Lefrere
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - D A Laplaud
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - C Brosset
- Military Hospital, Marseille, France
| | - P Derkinderen
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - J de Seze
- University of Strasbourg Hospital, Strasbourg, France
| | - S Wiertlewski
- Neurology Department, University of Nantes Hospital, Nantes, France
| | | |
Collapse
|
19
|
Lebrun C, de Seze J. Demyelinating diseases. Rev Neurol (Paris) 2018; 174:355. [DOI: 10.1016/j.neurol.2018.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/09/2018] [Accepted: 04/12/2018] [Indexed: 11/26/2022]
|
20
|
Lebrun C. Should we treat patients with radiologically isolated syndrome (RIS)? Comments. Rev Neurol (Paris) 2018; 174:696-698. [PMID: 29779851 DOI: 10.1016/j.neurol.2018.02.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/21/2017] [Accepted: 02/14/2018] [Indexed: 11/17/2022]
Affiliation(s)
- C Lebrun
- Centre de ressources et compétences SEP, Neurologie, université Nice Côte d'Azur, CHU Pasteur 2, 30, voie Romaine, 06002 Nice, France.
| |
Collapse
|
21
|
Mountjoy M, Sundgot-Borgen JK, Burke LM, Ackerman KE, Blauwet C, Constantini N, Lebrun C, Lundy B, Melin AK, Meyer NL, Sherman RT, Tenforde AS, Klungland Torstveit M, Budgett R. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br J Sports Med 2018; 52:687-697. [DOI: 10.1136/bjsports-2018-099193] [Citation(s) in RCA: 345] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2018] [Indexed: 01/20/2023]
|
22
|
Brier S, Le Mignon M, Jain K, Lebrun C, Peurois F, Kellenberger C, Bordas-Le Floch V, Mascarell L, Nony E, Moingeon P. Characterization of epitope specificities of reference antibodies used for the quantification of the birch pollen allergen Bet v 1. Allergy 2018; 73:1032-1040. [PMID: 29171882 DOI: 10.1111/all.13364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Accurate allergen quantification is needed to document the consistency of allergen extracts used for immunotherapy. Herein, we characterize the epitope specificities of two monoclonal antibodies used in an ELISA for the quantification of the major birch pollen allergen Bet v 1, established as a reference by the BSP090 European project. METHODS The ability of mAbs 5B4 and 6H4 to recognize Bet v 1 isoforms was addressed by immunochromatography. The capacity of each mAb to compete with patients' IgE for binding to Bet v 1 was measured by ELISA inhibition. Epitope mapping was performed by pepscan analysis, site-directed mutagenesis, and hydrogen/deuterium exchange-mass spectrometry. RESULTS The 5B4 epitope corresponds to a peptide sequence (I56-K68) overlapping with the binding sites of patients' serum IgEs. Mutation of residues P59, E60, and K65 abolishes 5B4 binding to Bet v 1 and reduces the level of IgE recognition. In contrast, 6H4 recognizes a conformational epitope lying opposite to the 5B4 binding site, involving residues located in segments I44-K55 and R70-F79. Substitution of E45 reduces the binding capacity of 6H4, confirming that it is critical for the interaction. Both mAbs interact with >90% of Bet v 1 content present in the birch pollen extract, while displaying a weak cross-reactivity with other allergens of the PR-10 family. CONCLUSIONS MAbs 5B4 and 6H4 recognize structurally distinct epitopes present in the vast majority of Bet v 1 isoforms. These results support the relevance as a reference method of the Bet v 1-specific quantitative ELISA adopted by the European Pharmacopoeia.
Collapse
Affiliation(s)
- S. Brier
- Research Department; Stallergenes Greer; Antony Cedex France
| | - M. Le Mignon
- Research Department; Stallergenes Greer; Antony Cedex France
| | - K. Jain
- Research Department; Stallergenes Greer; Antony Cedex France
| | - C. Lebrun
- Research Department; Stallergenes Greer; Antony Cedex France
| | - F. Peurois
- Research Department; Stallergenes Greer; Antony Cedex France
| | | | | | - L. Mascarell
- Research Department; Stallergenes Greer; Antony Cedex France
| | - E. Nony
- Research Department; Stallergenes Greer; Antony Cedex France
| | - P. Moingeon
- Research Department; Stallergenes Greer; Antony Cedex France
| |
Collapse
|
23
|
Cock VCD, Dotov D, Ihalainen P, Bégel V, Galtier F, Lebrun C, Picot M, Driss V, Landragin N, Geny C, Bardy B, Bella SD. Est-ce que les compétences rythmiques et musicales influencent la réponse à l’indiçage auditif au cours de la maladie de Parkinson ? Neurophysiol Clin 2017. [DOI: 10.1016/j.neucli.2017.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
24
|
Conte-Daban A, Boff B, Candido Matias A, Aparicio CNM, Gateau C, Lebrun C, Cerchiaro G, Kieffer I, Sayen S, Guillon E, Delangle P, Hureau C. A Trishistidine Pseudopeptide with Ability to Remove Both Cu Ι and Cu ΙΙ from the Amyloid-β Peptide and to Stop the Associated ROS Formation. Chemistry 2017; 23:17078-17088. [PMID: 28846165 PMCID: PMC5714062 DOI: 10.1002/chem.201703429] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Indexed: 01/08/2023]
Abstract
The pseudopeptide L, derived from a nitrilotriacetic acid scaffold and functionalized with three histidine moieties, is reminiscent of the amino acid side chains encountered in the Alzheimer's peptide (Aβ). Its synthesis and coordination properties for CuΙ and CuΙΙ are described. L efficiently complex CuΙΙ in a square-planar geometry involving three imidazole nitrogen atoms and an amidate-Cu bond. By contrast, CuΙ is coordinated in a tetrahedral environment. The redox behavior is irreversible and follows an ECEC mechanism in accordance with the very different environments of the two redox states of the Cu center. This is in line with the observed resistance of the CuΙ complex to oxidation by oxygen and the CuΙΙ complex reduction by ascorbate. The affinities of L for CuΙΙ and CuΙ at physiological pH are larger than that reported for the Aβ peptide. Therefore, due to its peculiar Cu coordination properties, the ligand L is able to target both redox states of Cu, redox silence them and prevent reactive oxygen species production by the CuAβ complex. Because reactive oxygen species contribute to the oxidative stress, a key issue in Alzheimer's disease, this ligand thus represents a new strategy in the long route of finding molecular concepts for fighting Alzheimer's disease.
Collapse
Affiliation(s)
- A. Conte-Daban
- CNRS, LCC (Laboratoire de Chimie de Coordination) 205 route de Narbonne,BP 44099 31077 Toulouse Cedex 4, France
- University of Toulouse, UPS, INPT 31077 Toulouse Cedex 4, France
| | - B. Boff
- Univ. Grenoble Alpes, CEA, CNRS, INAC, SyMMES (UMR 5819), CIBEST, 17 rue des martyrs, F-38 000 Grenoble, France
| | - A. Candido Matias
- Univ. Grenoble Alpes, CEA, CNRS, INAC, SyMMES (UMR 5819), CIBEST, 17 rue des martyrs, F-38 000 Grenoble, France
- Center for Natural Sciences and Humanities, Federal University of ABC – UFABC 09210-580, Santo André, SP, Brazil
| | - C. N. Montes Aparicio
- CNRS, LCC (Laboratoire de Chimie de Coordination) 205 route de Narbonne,BP 44099 31077 Toulouse Cedex 4, France
- University of Toulouse, UPS, INPT 31077 Toulouse Cedex 4, France
| | - C. Gateau
- Univ. Grenoble Alpes, CEA, CNRS, INAC, SyMMES (UMR 5819), CIBEST, 17 rue des martyrs, F-38 000 Grenoble, France
| | - C. Lebrun
- Univ. Grenoble Alpes, CEA, CNRS, INAC, SyMMES (UMR 5819), CIBEST, 17 rue des martyrs, F-38 000 Grenoble, France
| | - G. Cerchiaro
- Center for Natural Sciences and Humanities, Federal University of ABC – UFABC 09210-580, Santo André, SP, Brazil
| | - I. Kieffer
- BM30B/FAME beamline, ESRF, F-38043 Grenoble cedex 9, France
- Observatoire des Sciences de l’Univers de Grenoble, UMS 832 CNRS Université Grenoble Alpes, F-38041 Grenoble, France
| | - S. Sayen
- Institut de Chimie Moléculaire de Reims (ICMR, UMR CNRS 7312), Université de Reims Champagne-Ardenne, F-51687 Reims Cedex 2, France
| | - E. Guillon
- Institut de Chimie Moléculaire de Reims (ICMR, UMR CNRS 7312), Université de Reims Champagne-Ardenne, F-51687 Reims Cedex 2, France
| | - P. Delangle
- Univ. Grenoble Alpes, CEA, CNRS, INAC, SyMMES (UMR 5819), CIBEST, 17 rue des martyrs, F-38 000 Grenoble, France
| | - C. Hureau
- CNRS, LCC (Laboratoire de Chimie de Coordination) 205 route de Narbonne,BP 44099 31077 Toulouse Cedex 4, France
- University of Toulouse, UPS, INPT 31077 Toulouse Cedex 4, France
| |
Collapse
|
25
|
Bienvenu C, Lebrun C, Cadet J. Photo-sensitized formation of the cis-(5R, 6R) diastereomer of 5,6-dihydroxy-5,6-dihydro-5-methyl-2’-deoxycytidine. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1997940300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
26
|
Papeix C, Vidal JS, de Seze J, Pierrot-Deseilligny C, Tourbah A, Stankoff B, Lebrun C, Moreau T, Vermersch P, Fontaine B, Lyon-Caen O, Gout O. Immunosuppressive therapy is more effective than interferon in neuromyelitis optica. Mult Scler 2017; 13:256-9. [PMID: 17439893 DOI: 10.1177/1352458506070732] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To determine long-term treatment (LTT) of neuromyelitis optica (NMO), we retrospectively reviewed therapies of 26 patients with NMO followed in five French neurological departments. To assess LTT efficacy, the probability of relapse free after LTT was analysed. Patients were divided into two groups according to the first treatment receiving interferon beta (IFN Group, seven patients) or immunosuppressants (IS Group, 19 patients). The probability of relapse was significantly lower in the IS Group (P = 0.0007). From our results, interferon beta is not recommended, and one of the best current therapeutic options for NMO appears to be immunosuppressants. Multiple Sclerosis 2007; 13: 256–259. http://msj.sagepub.com
Collapse
Affiliation(s)
- C Papeix
- Department of Neurology, Hôpital de la Salpêtrière, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Cohen M, Romero G, Bas J, Ticchioni M, Rosenthal M, Lacroix R, Brunet C, Rico A, Pelletier J, Audoin B, Lebrun C. Monitoring CD27+ memory B-cells in neuromyelitis optica spectrum disorders patients treated with rituximab: Results from a bicentric study. J Neurol Sci 2017; 373:335-338. [PMID: 28131216 DOI: 10.1016/j.jns.2017.01.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 12/15/2016] [Accepted: 01/06/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Rituximab (RTX) is increasingly used in the treatment of neuromyelitis optica spectrum disorder (NMO-SD). Administration regimen is not consensual as there is no reliable biomarker of RTX efficacy. In most cases, after induction, RTX is administered systematically every 6months. OBJECTIVE To assess efficacy and safety of a maintenance regimen based on CD19+ CD27+ memory B-cell (mBc) detection. METHODS We conducted a study in two French centers, including patients with NMO-SD who received an induction therapy with RTX. We compared the number of administered infusions, relapses and EDSS depending on two maintenance schemes (S1: administration of 1g RTX infusion every 6months or S2: a scheme based on regular mBc detection. 1g RTX was administered if mBc was >0.05%) RESULTS: 40 patients were included (mean age: 40.2years, F/M sex ratio: 5/1). Aquaporin-4 antibodies were positive in 75% patients. Under S1 regimen, all patients received 2 infusions per year, whereas under S2, they received 1.62 infusion per year. The mean interval between infusions under S2 was 7.4months, without decrease of clinical efficacy. CONCLUSION In our study, mBc-based administration of RTX allowed personalizing treatment administration and in several cases to lower the cumulative dose without loss of efficacy.
Collapse
Affiliation(s)
- M Cohen
- Department of Neurology, Hôpital Pasteur 2, Nice, France.
| | - G Romero
- Department of Neurology, Hôpital Pasteur 2, Nice, France
| | - J Bas
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - M Ticchioni
- Department of Immunology, Hôpital l'Archet, Nice, France
| | - M Rosenthal
- Department of Immunology, Hôpital l'Archet, Nice, France
| | - R Lacroix
- Hematology and Vascular Biology Department, CHU La Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - C Brunet
- Hematology and Vascular Biology Department, CHU La Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - A Rico
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - J Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - B Audoin
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - C Lebrun
- Department of Neurology, Hôpital Pasteur 2, Nice, France
| |
Collapse
|
28
|
Lebrun C. [Internal fixation of the distal radius: Medical liability considerations]. Hand Surg Rehabil 2016; 35S:S162-S165. [PMID: 27890205 DOI: 10.1016/j.hansur.2016.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 03/11/2016] [Accepted: 04/21/2016] [Indexed: 11/16/2022]
Abstract
Fixation of distal radius fractures is now the primary surgical procedure leading to medical liability claims for surgeons dealing with injuries to the upper limb. The main reasons for incrimination are complex regional pain syndrome and an unfavorable progression toward malunion. Infectious problems are relatively rare and, in general, well controlled. The associated capsule and ligament damage can be underestimated at the time of the initial assessment, which points to the need for complementary imaging in case of doubt. The prevention of claims inevitably requires a judicious choice of the fixation technique, which is adapted to the anatomical fracture type and to the patient. The best defense is a complete medical record, with emphasis on traceable information.
Collapse
Affiliation(s)
- C Lebrun
- Cabinet Branchet, 34, avenue du Granier, 38240 Meylan, France.
| |
Collapse
|
29
|
de Seze J, Lebrun C, Stojkovic T, Ferriby D, Chatel M, Vermersch P. Is Devic's neuromyelitis optica a separate disease? A comparative study with multiple sclerosis. Mult Scler 2016; 9:521-5. [PMID: 14582780 DOI: 10.1191/1352458503ms947oa] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Devic's neuromyelitis optica (NMO) associates optic neuritis and myelopathy without other neurological signs. Many patients with NMO may be diagnosed as having multiple sclerosis (MS). However, there have been no previous studies comparing these two patho logies and it is still unclear if NMO is a separate entity or a subtype of MS. In the present study, we compared a series of NMO patients with a series of MS patients for whom optic neuritis or myelopathy was the presenting symptom, in order to determine the place of NMO in the spectrum of MS. We retrospectively studied 30 patients diagnosed with NMO and we compared these patients with 50 consecutive MS cases revealed by optic neuritis or acute myelopathy. MS patients were only included if a relapse occurred demonstrating time and space dissemination. We compared the two groups in terms of clinical presentatio n, laboratory findings (MRI and C SF) and clinical outcome. NMO patients were older and more frequently women than MS patients but the difference was not significant. C SF and MRI data were clearly different: oligoclonal bands (O C B) were found in 23% of NMO cases and 88% of MS (P B/0.001), abnormal brain MRI data were observed in 10% of NMO cases and 66% of MS (P B/0.001) and a large spinal cord lesion was observed in 67% of NMO cases and 7.4% of MS cases (P B/0.001). C linical outcome was evaluated as more severe in the NMO group (P B/0.001). O n the basis of clinical data, all NMO patients but three had dissemination in time and space. When we included MRI parameters, only two of the NMO patients met criteria for MS and one of the MS patients met criteria for NMO. O ur study demonstrates that NMO and MS should be considered as two different entities. The respective criteria for NMO and MS were able to distinguish these two patho logies but only when MRI data were applied. This finding could have implications for future therapeutic trials.
Collapse
Affiliation(s)
- J de Seze
- Department of Neurology, Hôpital R. Salengro, University of Lille, France.
| | | | | | | | | | | |
Collapse
|
30
|
Lebrun C, Alchaar H, Candito M, Bourg V, Chatel M. Levocarnitine administration in multiple sclerosis patients with immunosuppressive therapy-induced fatigue. Mult Scler 2016; 12:321-4. [PMID: 16764345 DOI: 10.1191/135248506ms1275oa] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Nutritional factors and comedications are among the postulated causes of fatigue, a highly prevalent symptom in the multiple sclerosis (MS) population, with serious impact on patients’ quality of life. Deficiency of carnitine may play a role by reducing energy production through fatty acid oxidation and numerous MS therapies can induce fatigue syndrome. The aim of this prospective open-labelled study was to collect and study serum carnitine levels in MS patients with and without disease-modifying treatment-induced fatigue syndrome. We investigated whether restoration of the carnitine pool might improve treatment-induced fatigue in MS patients. In our study, there was no statistical difference in fatigue frequency between treated and untreated patients ( P=0.5). Matched to age, gender and treatments, carnitine levels were lower for MS treated patients compared to untreated MS patients ( P<0.05) or controls ( P<0.001). Consecutive patients with low plasma carnitine levels who experienced fatigue were substituted. Treatment consisted of oral levocarnitine, 3-6 g daily. All patients achieved normal plasma carnitine levels. For 63% of patients treated with immunosuppressive or immunomodulatory therapies, oral levocarnitine adjunction decreased fatigue intensity, especially in patients treated with cyclophosphamide and interferon beta.
Collapse
Affiliation(s)
- C Lebrun
- Department of Neurology, Hôpital Pasteur, 30 voie romaine, 06002 Nice, France.
| | | | | | | | | |
Collapse
|
31
|
Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, Ljungqvist A, Ackerman K. RED-S CAT. Relative Energy Deficiency in Sport (RED-S) Clinical Assessment Tool (CAT). Br J Sports Med 2015; 49:421-3. [PMID: 25896450 DOI: 10.1136/bjsports-2015-094873] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, Ljungqvist A, Ackerman K. The IOC relative energy deficiency in sport clinical assessment tool (RED-S CAT). Br J Sports Med 2015; 49:1354. [PMID: 26764434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
33
|
|
34
|
|
35
|
Sijobert B, Lebrun C, Begel V, Verna C, Castelnovo G, Dalla Bella S, Coste C, Geny C. Interest of the task of “Stepping in place” in the assessment of freezing in Parkinson's disease patients. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
36
|
Lebrun C, Vermersch P. [A breakthrough for the treatment of spasticity in multiple sclerosis]. Rev Neurol (Paris) 2015; 171:327-8. [PMID: 25835097 DOI: 10.1016/j.neurol.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/02/2015] [Indexed: 11/26/2022]
Affiliation(s)
- C Lebrun
- Service de neurologie, CHU Pasteur, 30, voie Romaine, 06000 Nice cedex, France.
| | - P Vermersch
- Service de neurologie, CHU Salengro, rue Émile-Laine, 59037 Lille, France
| |
Collapse
|
37
|
Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, Ljungqvist A. Authors’ 2015 additions to the IOC consensus statement: Relative Energy Deficiency in Sport (RED-S). Br J Sports Med 2015; 49:417-20. [DOI: 10.1136/bjsports-2014-094371] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
38
|
Lebrun C, Forzy G, Collongues N, Cohen M, de Seze J, Hautecoeur P. Tear analysis as a tool to detect oligoclonal bands in radiologically isolated syndrome. Rev Neurol (Paris) 2015; 171:390-3. [PMID: 25613196 DOI: 10.1016/j.neurol.2014.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 11/14/2014] [Accepted: 11/18/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although radiologically isolated syndrome (RIS) is a newly defined entity, incidental findings of T2 hypersignals on brain MRI can lead to misdiagnosis or useless investigations. The detection of oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is a major indicator that helps in diagnosis of subclinical inflammatory disease of the central nervous system, but lumbar puncture still remains an invasive option. METHODS We have prospectively included patients with RIS, have compared the results of CSF and tear OCB detection by isoelectric focusing (IEF) and assessed concordance between OCB detection in tears and in CSF. Tears were collected using a Schirmer strip. RESULTS In 45 recruited RIS patients, OCBs were detected in CSF for 55% (25/45) and in tears for 50% (21/42) of samples. CONCLUSIONS We suggest that tear OCB detection may replace CSF OCB detection as a diagnostic tool in patients with RIS and be useful in follow-up.
Collapse
Affiliation(s)
- C Lebrun
- Service de neurologie, hôpital Pasteur, CHU de Nice, 30, voie Romaine, 06002 Nice, France.
| | - G Forzy
- Centre catholique de Lomme, université catholique de Lille, 56, rue du Port, 59046 Lille, France
| | - N Collongues
- Neurologie, CHU de Strasbourg, 1, place de L'hôpital, BP 426, 67091 Strasbourg cedex, France
| | - M Cohen
- Service de neurologie, hôpital Pasteur, CHU de Nice, 30, voie Romaine, 06002 Nice, France
| | - J de Seze
- Neurologie, CHU de Strasbourg, 1, place de L'hôpital, BP 426, 67091 Strasbourg cedex, France
| | - P Hautecoeur
- Centre catholique de Lomme, université catholique de Lille, 56, rue du Port, 59046 Lille, France
| | | |
Collapse
|
39
|
Lebrun C, de Seze J. [Two new oral disease modifying therapies in relapsing remitting multiple sclerosis]. Rev Neurol (Paris) 2014; 170:721-2. [PMID: 25487772 DOI: 10.1016/j.neurol.2014.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 10/11/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
Affiliation(s)
- C Lebrun
- Service de neurologie, hôpital Pasteur, 30, avenue de la voie romaine, BP 69, 06002 Nice cedex 1, France.
| | - J de Seze
- Service de neurologie, hôpital Hautepierre, avenue Molière, 67000 Strasbourg, France
| |
Collapse
|
40
|
Lebrun C. [Medical liability issues]. ACTA ACUST UNITED AC 2014; 33 Suppl:S89-91. [PMID: 25088324 DOI: 10.1016/j.main.2014.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 06/23/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
Abstract
Of the 1603 civil liability cases filed between 2002 and 2012 related to upper-limb surgery, we found 20 proceedings (11 in court and 9 in front of the French CCI [commission for medical accidents]) that involved a total of 24 physicians: three proceedings involved multiple parties for a single patient and implicated two physicians in two cases and three physicians in one case. The grounds for liability being invoked varied greatly, but a good many of these cases concerned outcomes that were deemed unsatisfactory or insufficient in light of the initial injury. Information is always difficult to convey in an emergency setting, but is not generally disputed. However, the information process must be completed during the postoperative period and the patient informed of the injury assessment, expected results, potential complications and the possibility of surgical revision in the medium term. An expert found grounds for physician liability and breach of best practices in only three cases. In summary, this study shows that trauma-related flexor tendon injuries are rarely grounds for indictment of physicians before courts of civil jurisdiction (12 per 1000) and findings of liability for breach of best practices are even more rare (2 per 1000).
Collapse
Affiliation(s)
- C Lebrun
- Cabinet Branchet, 35, avenue du Granier, 38240 Meylan, France.
| |
Collapse
|
41
|
Joly H, Cohen M, Lebrun C. Demonstration of a lexical access deficit in relapsing-remitting and secondary progressive forms of multiple sclerosis. Rev Neurol (Paris) 2014; 170:527-30. [DOI: 10.1016/j.neurol.2014.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 03/19/2014] [Accepted: 05/07/2014] [Indexed: 11/28/2022]
|
42
|
Morrier M, Ogielska M, Lebrun C, De Gialluly C, François P, Garot D, Bernard L. H-04: Méningites sur brèches ostéo-méningées : étiologies, prise en charge et évolution. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70184-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
43
|
Étienne P, Buffet S, Escoffier B, Lebrun C, Le Floch P, Bardagi L. O-04: Colonisation à entérobactéries multi résistantes aux antibiotiques (E-BMR) des patients entrant en soins de suite et réadaptation (SSR). Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70283-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
44
|
Lebrun C, Mondot L, Bourg V, Burel-Vandenbos F, Fontaine D. Uncommon foreign body reaction caused by derivation drain mimicking high grade CNS tumor. J Neurol Sci 2014; 340:237-8. [PMID: 24635892 DOI: 10.1016/j.jns.2014.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 02/12/2014] [Accepted: 02/18/2014] [Indexed: 10/25/2022]
Affiliation(s)
- C Lebrun
- Federation de Neuro Oncologie, Neurology, Nice, France.
| | - L Mondot
- Federation de Neuro Oncologie, Neuroradiology, Nice, France
| | - V Bourg
- Federation de Neuro Oncologie, Neurology, Nice, France
| | | | - D Fontaine
- Federation de Neuro Oncologie, Neurosurgery, Nice, France
| |
Collapse
|
45
|
Joly H, Cohen M, Brochet B, Clavelou P, Le Page E, Vermersch P, Lebrun C. L’impact de la vitesse de traitement sur les capacités langagières dans le syndrome cliniquement isolé. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
46
|
Cohen M, Bertagna M, Gressier R, Lebrun C. Présentation d’une plate-forme d’éducation thérapeutique dans la sclérose en plaques intégrant l’usage des nouvelles technologies : le projet ÉduSEP. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
47
|
Cohen M, Brochet B, Clavelou P, Lepage E, Vermersch P, Tourbah A, Lebrun C. Valeur prédictive de l’IRM et du dysfonctionnement cognitif sur la qualité de vie des patients après un premier évènement démyélinisant : analyse des résultats de l’étude qualicis. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
48
|
Le Page E, David V, Laplaud D, Wardi R, Lebrun C, Deburghgraeve V, Coustans M. COPOUSEP : corticoïdes à forte dose par voie orale versus intraveineuse dans le traitement des poussées de sclérose en plaques : un essai randomisé en double insu : résultats du critère majeur d’efficacité à 1 mois. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
49
|
Lebrun C, Mrazik M, Prasad A, Taylor T, Jevremovic T. SPORT CONCUSSION KNOWLEDGE BASE AND CURRENT PRACTICE– A SURVEY OF PHYSICIAN SECTIONS FROM THE ONTARIO MEDICAL ASSOCIATION. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
50
|
Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, Ljungqvist A. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). Br J Sports Med 2014; 48:491-7. [DOI: 10.1136/bjsports-2014-093502] [Citation(s) in RCA: 720] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|