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Tracking concussion care in high school athletes

By Chelsea Conaboy
Globe Staff / November 21, 2011
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Dozens of states have created rules in recent years dictating how high school athletes who are suspected of having a concussion are treated. Many, including Massachusetts, require a doctor to clear them before they play again.

To get a better idea of how concussions are monitored in high schools now, a group of researchers from Children’s Hospital Boston and Nationwide Children’s Hospital in Ohio collected injury data from 20 sports at 192 schools that had an athletic trainer on staff in the 2009-2010 academic year. Of the 7,257 injuries reported, about 15 percent were concussions. About 76 percent of concussions were in male athletes, 11 percent were repeat concussions, and most occurred in varsity sports.

About 59 percent of concussions were assessed by a primary care physician. The authors note that many doctors who are not sports specialists may not be up to date on the latest concussion management guidelines and more outreach is needed.

At least 2.5 percent of athletes were returned to play after assessment by someone, often a coach, who was not a medical professional. The authors note that number likely is higher at schools without an athletic trainer.

BOTTOM LINE: About 15 percent of all sports-related injuries in high school athletes are concussions, and 59 percent of concussions are assessed by primary care providers.

CAUTIONS: The study looked only at schools with an athletic trainer.

WHERE TO FIND IT: American Journal of Sports Medicine, November 2011

Less risks for heavy kids who become normal-weight adults

People who were heavy as children but who are not overweight as adults have no greater risk of becoming diabetic or having high cholesterol than those who maintain a normal weight from childhood to adulthood, a new study found.

An international group of researchers looked at data from 6,328 people followed in four long-term studies. Being an overweight child is a predictor for becoming an overweight adult. But among the 274 people whose weight normalized as adults, the risk of type 2 diabetes and high cholesterol was not significantly elevated, compared with those who were never obese. The study did find that the group had an increased risk of high blood pressure, but even that was lower than the risk for those who remained obese as adults.

The authors said that helping children and adolescents to lose weight may moderate their risk, and that “primary care physicians should not take the pessimistic view’’ that cardiovascular risk is determined by childhood weight.

BOTTOM LINE: Overweight children who become obese adults have an increased risk of type 2 diabetes and high blood pressure or cholesterol. But those risks are reduced among those who become nonobese adults.

CAUTIONS: The researchers could not analyze at what age people’s weight normalized. The study participants were primarily white.

WHERE TO FIND IT: New England Journal of Medicine, Nov. 17 CHELSEA CONABOY

Chelsea Conaboy can be reached at cconaboy@boston.com. Follow her on Twitter @cconaboy.

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