Category Archives: Professional

Researchers Hope New Biomarkers Will Lead to Potentially Life-Saving Sports Pitch-Side Test for Brain Injury

Researchers at the University of Birmingham have identified inflammatory biomarkers which indicate whether the brain has suffered injury.

The team, led by Professor Antonio Belli, at the University’s College of Medical and Dental Sciences, now hopes to use these new biomarkers to develop a test which can be used on the side of a sports pitch or by paramedics to detect brain injury at the scene of an incident.

Dr Lisa Hill, of the Institute of Inflammation and Ageing at the University of Birmingham, said: “Traumatic brain injury (TBI) is the leading cause of death and disability among young adults and, according to the World Health Organization, by 2020 TBI will become the world’s leading cause of neurological disability across all age groups.

“Early and correct diagnosis of traumatic brain injury is one of the most challenging aspects facing clinicians.

“Being able to detect compounds in the blood which help to determine how severe a brain injury is would be of great benefit to patients and aid in their treatment.

“Currently, no reliable biomarkers exist to help diagnose the severity of TBI to identify patients who are at risk of developing secondary injuries that impair function, damage other brain structures and promote further cell death.

“Thus, the discovery of reliable biomarkers for the management of TBI would improve clinical interventions.”

Inflammatory markers are particularly suited for biomarker discovery as TBI leads to very early alterations in inflammatory proteins.

In this novel study published today in Scientific Reports, blood samples were taken from 30 injured patients within the first hour of injury prior to the patient arriving at hospital.

Subsequent blood samples were taken at intervals of four hours, 12 hours and 72 hours after injury. These blood samples were then screened for inflammatory biomarkers which correlated with the severity of the injury using protein detection methods.

In the laboratory, the team used a panel of 92 inflammation-associated human proteins when analysing the blood samples, which were screened simultaneously.

The serum biomarkers were analysed from patients with mild TBI with extracranial injury, severe TBI with extracranial injury and extracranial injury only and all groups were compared to a control group of healthy volunteer patients.

The results identified three inflammatory biomarkers, known as CST5, AXIN1 and TRAIL, as novel early biomarkers of TBI.

CST5 identified patients with severe TBI from all other cohorts and, importantly, was able to do so within the first hour of injury.

AXIN1 and TRAIL were able to discriminate between TBI and uninjured patient controls in under an hour.

Dr Valentina Di Pietro, also of the Institute of Inflammation and Ageing at the University of Birmingham, said: “Early and objective pre-hospital detection of TBI would support clinical decision making and the correct triage of major trauma.

“Moreover, the correct diagnosis of TBI, which is one of hardest diagnosis to make in medicine, would allow clinicians to implement strategies to reduce secondary brain injury at early stage, for example, by optimising blood and oxygen delivery to the brain and avoiding manoeuvres that could potentially increase intracranial pressure.

“In addition, this has potential implications for drug development, as novel compounds could be given immediately after injury and potentially commenced at the roadside, if there was sufficient confidence in the diagnosis of TBI.

“We conclude that CST5, AXIN1 and TRAIL are worthy of further study in the context of a pre-hospital or pitch-side test to detect brain injury.”

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July 2017 Issue of Concussion Litigation Reporter

Here’s the table of contents of the July 2017 (Vol. 6, No. 1) issue of Concussion Litigation Reporter, which features timely reporting on developments and legal strategies at the intersection of sports and concussions.

Articles

  • Fourth Circuit Affirms Lower Court Ruling, Finding NFL’s Post-Retirement Disability Apparatus Failed Ex-Player
  • Court Dismisses Concussion Lawsuit Against Coach as Her Inexperience Works in Her Favor
  • Boogaard Ruling Blurs NHL Liability in Head-Injury Suits
  • Negligence or Assumption of Risk? The Case of Rugby Player George North
  • A Boxing Tragedy: The Prichard Colon Case
  • Bylaw Giving Teeth to Physicians and Athletic Trainers in Return-to-Play Decisions Set to Kick Off for Division II and III
  • Head Impact Exposure Increases as Youth Football Players Get Older, Bigger
  • Magistrate Recommends That Some of Omnibus Claim From Mother and Her Concussed Daughter Can Continue
  • Looking in all the Wrong Places: The Tragic Death of Aaron Hernandez
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North Carolina Return to Play Lawsuit Puts Spotlight on Such Protocols

(Editor’s Note: What follows is an excerpt from the recent issue of Concussion Litigation Reporter. To read the full article, please subscribe at http://concussionpolicyandthelaw.com/subscribe/) 

By Gary Wolensky, Anne Marie Ellis, and Paul Alarcon, of Buchalter (www.buchalter.com)

On Sept. 27, 2014, 17-year-old Isaiah Langston, a Rolesville High School football player, suffered a concussion-producing collision with another teammate during a team practice.

According to a lawsuit recently filed by Langston’s family in North Carolina, Rolesville’s failure to properly respond to this concussion led to the teen’s death. In its complaint, the family alleges that while Rolesville’s coaches and staff checked Langston and sat him out for the remainder of practice, they never notified his parents of his injury and subsequently allowed Langston to return two days later to participate in pre-game drills and warm-ups without obtaining any medical clearance. The family alleges that Langston began complaining of head pain during these drills and then collapsed and died shortly thereafter.

In its lawsuit, Langston’s family alleges that Rolesville violated North Carolina’s “Return to Play” laws enacted to prevent concussion-related injuries arising when a youth sports participant returns to play after suffering a concussion. Return to Play laws have been enacted in some form by every state in the country in response to the changing landscape of concussion awareness in youth sports. Such laws are intended to increase awareness and care in addressing concussions. Specifically, Return to Play laws generally impose educational, training and notification requirements designed to ensure that coaches, parents, and youth athletes are better educated about the signs and risks of concussions.

The Return to Play laws enacted in California are among the most robust in the country. Specifically, California’s Education Code imposes an array of concussion and head-injury related obligations on any school districts, charter schools, and private schools that offer an athletic program. Seee.g., Cal. Educ. Code § 49475(a). If a coach or administrator suspects that an athlete sustained a concussion or head injury, the athlete must be removed from play for the remainder of the day as well as receive an evaluation from a licensed health care practitioner with expertise in concussion-related injuries. Id. at § 49475(a)(1). If no concussion is diagnosed, the athlete must receive a written medical clearance before returning to practice. Id. If a concussion is diagnosed, then the athlete must complete a graduated return-to-play protocol for seven days under the supervision of a health care practitioner. Id. Lastly, athletes and their parents must sign an annual concussion and head-injury information sheet. Id. at 49475(a)(2).

Additionally, California recently dramatically expanded the scope of its Return to Play laws. Specifically, California’s new statutory requirements …

 

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