This week the panel are joined by Michael Brady, the national advisor for LGBT Health to discuss why your patient’s queerness might matter to you, and how to practice inclusively, as well as an interview with Lisa Power MBE,  a British sexual health and LGBT rights campaigner. Have a listen to hear Michael Brady answering your questions, agony aunt style!

Inclusive Practice

The mental health of athletes has been in the spotlight throughout this summer, as high-profile athletes such as Naomi Osaka and Simone Biles have spoken out about the importance of prioritizing their physical, and especially their mental, well-being.

In this episode, host Dr. Giselle Aerni, MD is joined by AMSSM Past Presidents Dr. Cindy Chang, MD and Dr. Margot Putukian, MD to discuss the AMSSM Position Statement on Mental Health Issues and Psychological Factors in Athletes, which Dr. Aerni also co-authored.

In this 33-minute conversation, they address the following topics:
The importance of a position statement on the mental health of athletes and the novel aspects addressed in the document
The team-based approach to mental health care and why it’s a crucial component for the well-being of athletes
How the acceptance of mental health issues has evolved in recent years and the impact social media has on those perceptions
The impact of the COVID-19 pandemic on athletes’ mental health and how it reinforces the need for conversations about this vital issue

Resources:
Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement (https://bjsm.bmj.com/content/54/4/216.full)
Madam Athlete Podcast (https://madamathlete.com/)

The Importance of Mental Health in Athletes with Two AMSSM Past Presidents EP #483

Dr Donald Shelbourne is an orthopedic surgeon at The Shelbourne Clinic in Indianapolis, Indiana. He has performed more than 6,000 ACL reconstructions since 1982 and he is credited with developing the ‘accelerated rehabilitation program’. He discusses the history of the field and how he contributed to eliminating the big problem of the ‘stiff stable’ knee. He does NOT detail the rehabilitation method itself. He has an interesting thought on the role of ACL reconstruction in young people who suffer ACL tears. 

See the timeline below that includes a paper referred to in the discussion and two additional BJSM resources. If I had to create a short slogan for the podcast I would go with ‘Symmetric Motion is Key’.  

1:00 How Dr Shelbourne discovered accelerated rehabilitation  
3:00 The problem of knees that were too stiff after ACL surgery in the 1980s. 
4:00 The problem of excessively large ACL grafts and graft hypertrophy blocking knee extension
4:40 Casts contributing to knees becoming ‘stiff-stable’. Knees not returning to full extension (1980s)
6:00 Moving patients from plaster to one hour a day of a limited motion brace
6:50 Dr Shelbourne comments on augmented lateral procedures today. Discusses hamstring grafts and allografts in this context. His rationale for ipsilateral patellar tendon grafts. 
9:40 Patellar tendon donor site problems – the role of physiotherapy in solving the problem
9:10 A comment on Dr Leo Pinzewski’s 20 year post-ACL surgery followup study. (Hamstring graft) Paper in American Journal of Sports Medicine (http://ow.ly/hcRx300Eb58). See also Professors Hutchinson and McCormack discuss that paper in BJSM (http://ow.ly/f1JM300EcQ0). They also have a new editorial on ACL outcomes online first as this podcast goes live (http://ow.ly/gqdk300Edm7). 
10:50 Stiffness is not acceptable. Patients prefer a bit of instability with full range of motion than a stiff stable knee. Stiff knee is a time bomb for osteoarthritis.
12:00 Who should have an ACL reconstruction? About half of patients who have ACL injuries are not getting back to sport at the previous level. “In a way you are much better off having non-operative treatment….”
13:00 If you are wondering whether to have surgery or not after ACL injury – go for conservative management first. “Nothing to lose”. “A stiff knee is a time bomb for osteoarthritis later on.”
13:45 Osteoarthritis. Patients who don’t get all their movement back have a high risk of osteoarthritis moving forward. Many surgeons overlook the loss of motion as a risk factor. 

Related podcasts: 
Dr Mark Hutchinson on ACL reconstruction: https://soundcloud.com/bmjpodcasts/markhutchinson2?in=bmjpodcasts/sets/bjsm-1
Dr Mark Hutchinson on meniscectomy for symptoms of painful locking and clicking: https://soundcloud.com/bmjpodcasts/mark-hutchinson?in=bmjpodcasts/sets/bjsm-1


The father of accelerated rehabilitation, Dr Don Shelbourne, on history and managing ACL injuries

In this episode of the Heart podcast, Digital Media Editor Dr. James Rudd is joined by a vascular biology legend, Professor Peter Libby from Harvard University and Chief of Cardiovascular Medicine at Brigham and Women's Hospital in Boston. They discuss how the inflammation hypothesis of atherosclerosis has been proven by the CANTOS trial and what the future might hold. We trust you'll enjoy the police sirens in the middle of the interview and hope you enjoy the discussion.

Link for CANTOS study - http://www.nejm.org/doi/full/10.1056/NEJMoa1707914

Inflammation and heart disease - what's next?

In this episode of the Heart podcast, Digital Media Editor DrJames Rudd is joined by Dr Cara Hendry from Manchester and Dr Iain Simpson from Southampton. They are passionate about reducing barriers that exist in cardiology and other medical specialities. They discuss what the issues are and what is being done to help in the UK and beyond. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Women in cardiology - breaking down the barriers

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Professor Charalambos Antoniades from Oxford, UK. They discuss his novel method of measuring coronary plaque inflammation using CT imaging, and how this method might be important for predicting heart attacks.
If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://heart.bmj.com/content/early/2018/07/24/heartjnl-2017-312324

Perivascular adipose tissue and coronary atherosclerosis

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Charlotte Warren-Gash from the London School of Hygiene and Tropical Medicine. They discuss the links between respiratory infections and subsequent heart attacks and strokes.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://www.lshtm.ac.uk/newsevents/news/2018/respiratory-infections-could-increase-risk-heart-attack-and-stroke

Respiratory infections and subsequent heart attacks and strokes

In this episode of the Heart podcast, Digital Media Editor Dr James Rudd, is joined by Professor Bernard Prendergast from St Thomas' Hospital, London. They discuss his recent publication in Heart concerning the ability of the stethoscope to detect important valve disease in asymptomatic primary care patients. They also cover POCUS, the feasibility of screening elderly patients for valve disease and whether Bernard still uses a stethoscope in real life.

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: 
Primary paper: https://heart.bmj.com/content/early/2018/07/24/heartjnl-2018-313082
Editorial: https://heart.bmj.com/content/early/2018/05/24/heartjnl-2018-313474
The Oxvalve study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216199/

Do we still need stethoscopes?

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Eric Topol, founder and director of the Scripps Research Translational Institute. They discuss the impact that AI will have in medicine and how this will affect us all.

Relevant links related to this podcast:
About Dr Topol - https://drerictopol.com/about/
Nature Medicine AI review - https://www.nature.com/articles/s41591-018-0300-7
Twitter - https://twitter.com/EricTopol?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
Book - https://drerictopol.com/book/deep-medicine/
NHS Topol review - https://www.hee.nhs.uk/our-work/topol-review

Deep Medicine with Eric Topol, author of the Topol NHS review

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Thomas Butler from the University of Chester. They discuss his Review paper in Heart entitled "Optimum nutritional strategies for cardiovascular disease prevention and rehabilitation (BACPR)".

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: https://heart.bmj.com/content/106/10/724

Diet after a heart attack - what should we tell patients?

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by lipid expert Dr Susan Connolly from Enniskillen, Northern Ireland. They discuss primary and secondary prevention, risk scores, imaging and two new drugs with the potential to improve lipid management significantly over the next 5 years.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

The father of accelerated rehabilitation, Dr Don Shelbourne, on history and managing ACL injuries

BMJ talk medicine

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