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Article: Training Background and Demographic Characteristics of Primary Care Team Physicians in Professional Sports.

Schultz, Emily A / Durtschi, Maxwell S / Oakes, Kylie G / Kussman, Andrea / Hwang, Calvin E

2024 Volume 12, Issue 4, Page(s) 23259671241242412

Abstract: Background: Previous studies have shown that most professional head and orthopaedic team physicians are men, and most orthopaedic team physicians are fellowship-trained. It is unknown whether this holds true for primary care team physicians.: Purpose!# ...

Abstract	Background: Previous studies have shown that most professional head and orthopaedic team physicians are men, and most orthopaedic team physicians are fellowship-trained. It is unknown whether this holds true for primary care team physicians. Purpose: To evaluate the residency and fellowship training background as well as the demographic characteristics of primary care team physicians in professional sports. Study design: Cross-sectional study. Methods: Publicly available information was used to determine the lead and supporting primary care team physicians for every US-based team in Major League Baseball, Major League Soccer, National Basketball Association, National Football League, National Hockey League, National Women's Soccer League, and Women's National Basketball Association. Data regarding training background and sex were obtained using internet-based sources. Results: We identified 310 primary care team physicians from all 165 US-based teams in the 7 leagues included in the study. Female physicians comprised 11.5% (19/165) of the lead primary care team physicians and 14.2% (44/310) of all primary care team physicians. Overall, 66.7% (110/165) of lead primary care team physicians and 75.5% (234/310) of all primary care team physicians were sports medicine fellowship-trained. There was a higher proportion of female (37.5%) and fellowship-trained (93.8%) physicians in women's professional sports leagues. Most primary care team physicians (244/310 [78.7%]) were trained in family medicine or internal medicine. Conclusion: Women constituted a small minority of primary care team physicians in professional sports. Most primary care team physicians were residency trained in family medicine or internal medicine and were sports medicine fellowship-trained. The proportion of female and fellowship-trained primary care team physicians was highest in the National Women's Soccer League and the Women's National Basketball Association.
Language	English
Publishing date	2024-04-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2706251-X
ISSN	2325-9671
ISSN	2325-9671
DOI	10.1177/23259671241242412
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Adenovirus Infection and Rhabdomyolysis as a Cause of Acute Liver Failure in a Healthy Collegiate Football Athlete: A Case Report and Proposed Return to Play Protocol for Rhabdomyolysis.

Hwang, Calvin E / Matheson, Gordon / Baine, Jennifer

Cureus

2021 Volume 13, Issue 4, Page(s) e14510

Abstract: Adenovirus is a common cause of upper respiratory and gastrointestinal tract infections. Though cases of significant organ failure and death have been reported in young children and immunocompromised individuals, adenovirus infections in healthy ... ...

Abstract	Adenovirus is a common cause of upper respiratory and gastrointestinal tract infections. Though cases of significant organ failure and death have been reported in young children and immunocompromised individuals, adenovirus infections in healthy individuals are typically self-limiting without significant morbidity or mortality. Exertional rhabdomyolysis is a pathologic condition resulting from repetitive, excessive, or prolonged exercise, often in a hot environment, leading to acute muscle injury, renal injury and, rarely, death. We report a case of adenovirus infection leading to acute liver failure complicated by rhabdomyolysis in a collegiate football player presenting with nausea, vomiting, and diarrhea. We propose a protocol to safely guide the return to play progression for patients with complicated exertional rhabdomyolysis.
Language	English
Publishing date	2021-04-15
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.14510
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Article ; Online: Use of Monospot Testing in the Diagnosis of Infectious Mononucleosis in the Collegiate Student-Athlete Population.

Wang, Eric X / Kussman, Andrea / Hwang, Calvin E

Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine

2021 Volume 32, Issue 5, Page(s) 467–470

Abstract: Objective: To determine the utility of monospot testing in the diagnosis of mononucleosis in the collegiate student-athlete clinical setting.: Design: Retrospective cohort study.: Setting: National Collegiate Athletic Association Division I sports ...

Abstract	Objective: To determine the utility of monospot testing in the diagnosis of mononucleosis in the collegiate student-athlete clinical setting. Design: Retrospective cohort study. Setting: National Collegiate Athletic Association Division I sports medicine clinic. Patients: All varsity student athletes who had a monospot test and Epstein-Barr virus (EBV) titers obtained from January 1, 2016, through March 31, 2020, (n = 199) were included. Independent variables: Monospot, EBV antibody titers, and liver transaminase results. Main outcome measures: Using EBV titers indicating acute or recent infection as the gold standard for diagnosing infectious mononucleosis (IM), the reliability of a positive monospot test and elevated liver transaminases for the diagnosis of IM were examined. Results: The monospot test had a sensitivity and specificity of 80.0% and 90.6%, respectively, with a positive predictive value of 36.4% and a negative predictive value of 98.5% in this cohort. All athletes diagnosed with IM also had elevated liver transaminases. Conclusions: The specificity of the monospot test is lower than previously reported in the literature, and a positive test is not sufficient to diagnose mononucleosis in this clinical setting. Positive monospot results should be confirmed with EBV antibody testing. Elevated transaminase levels are highly correlated with acute IM and could play a supporting role in the diagnosis.
MeSH term(s)	Athletes ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Humans ; Infectious Mononucleosis/diagnosis ; Reproducibility of Results ; Retrospective Studies ; Students ; Transaminases
Chemical Substances	Transaminases (EC 2.6.1.-)
Language	English
Publishing date	2021-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1062530-6
ISSN	1536-3724 ; 1050-642X
ISSN (online)	1536-3724
ISSN	1050-642X
DOI	10.1097/JSM.0000000000000996
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Article ; Online: Use of Platelet-Poor Plasma in Acute Quadriceps Muscle Strain in a Division I Football Placekicker: A Case Report.

Kasitinon, Donald / Dragoo, Jason L / Hwang, Calvin E

Current sports medicine reports

2021 Volume 20, Issue 11, Page(s) 572–574

MeSH term(s)	Football ; Humans ; Quadriceps Muscle ; Soccer ; Sprains and Strains
Language	English
Publishing date	2021-11-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2080040-X
ISSN	1537-8918 ; 1537-890X
ISSN (online)	1537-8918
ISSN	1537-890X
DOI	10.1249/JSR.0000000000000901
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Article ; Online: Splenomegaly from Recurrent Infectious Mononucleosis in an NCAA Division I Athlete.

Bakal, David R / Kasitinon, Donald / Kussman, Andrea L / Hwang, Calvin E

Current sports medicine reports

2021 Volume 20, Issue 10, Page(s) 511–513

MeSH term(s)	Athletes ; Humans ; Infectious Mononucleosis/complications ; Infectious Mononucleosis/diagnosis ; Neoplasms ; Recurrence ; Splenomegaly
Language	English
Publishing date	2021-11-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2080040-X
ISSN	1537-8918 ; 1537-890X
ISSN (online)	1537-8918
ISSN	1537-890X
DOI	10.1249/JSR.0000000000000887
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Article: Increased Lower Extremity Injury Risk Associated With Player Load and Distance in Collegiate Women's Soccer.

Xiao, Michelle / Nguyen, Jessica N / Hwang, Calvin E / Abrams, Geoffrey D

Orthopaedic journal of sports medicine

2021 Volume 9, Issue 10, Page(s) 23259671211048248

Abstract: Background: There is limited research regarding the impact of workload on injury risk specific to women's soccer. Wearable global positioning system (GPS) units can track workload metrics such as total distance traveled and player load during games and ... ...

Abstract	Background: There is limited research regarding the impact of workload on injury risk specific to women's soccer. Wearable global positioning system (GPS) units can track workload metrics such as total distance traveled and player load during games and training sessions. These metrics can be useful in predicting injury risk. Purpose: To examine the relationship between injury risk and player workload as collected from wearable GPS units in National Collegiate Athletic Association (NCAA) Division I women's soccer players. Study design: Case-control study; Level of evidence, 3. Methods: Lower extremity injury incidence and GPS workload data (player load, total distance, and high-speed distance) for 65 NCAA Division I women's soccer players were collected over 3 seasons. Accumulated 1-, 2-, 3-, and 4-week loads and acute-to-chronic workload ratios (ACWR) were classified into discrete ranges by Results: There were a total of 53 lower extremity injuries that resulted in lost time recorded (5.76/1000 hours "on-legs" exposure time; 34 noncontact and 19 contact injuries). The prior 2-week (7242 vs 6613 m/s Conclusion: Higher accumulated player load and total distance, but not ACWR, were associated with injury in women's soccer players.
Language	English
Publishing date	2021-10-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2706251-X
ISSN	2325-9671
ISSN	2325-9671
DOI	10.1177/23259671211048248
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Article ; Online: Comparison of SARS-CoV-2 Test Positivity in NCAA Division I Student Athletes vs Nonathletes at 12 Institutions.

Schultz, Emily A / Kussman, Andrea / Jerome, Alyssa / Abrams, Geoffrey D / Hwang, Calvin E

JAMA network open

2022 Volume 5, Issue 2, Page(s) e2147805

Abstract: Importance: The COVID-19 pandemic initially led to the abrupt shutdown of collegiate athletics until guidelines were established for a safe return to play for student athletes. Currently, no literature exists that examines the difference in SARS-CoV-2 ... ...

Abstract	Importance: The COVID-19 pandemic initially led to the abrupt shutdown of collegiate athletics until guidelines were established for a safe return to play for student athletes. Currently, no literature exists that examines the difference in SARS-CoV-2 test positivity between student athletes and nonathletes at universities across the country. Objective: To identify the difference in risk of COVID-19 infection between student athlete and nonathlete student populations and evaluate the hypothesis that student athletes may display increased SARS-CoV-2 test positivity associated with increased travel, competition, and testing compared with nonathletes at their respective universities. Design, setting, and participants: In this cross-sectional analysis, a search of publicly available official university COVID-19 dashboards and press releases was performed for all 65 Power 5 National Collegiate Athletic Association (NCAA) Division I institutions during the 2020 to 2021 academic year. Data were analyzed at the conclusion of the academic year. Schools that released at least 4 months of testing data, including the fall 2020 football season, for student athletes and nonathlete students were included in the analysis. Power 5 NCAA Division I student athletes and their nonathlete student counterparts were included in the analysis. Exposure: Designation as a varsity student athlete. Main outcomes and measures: The main outcome was SARS-CoV-2 test positivity for student athletes and nonathlete students at the included institutions for the 2020 to 2021 academic year, measured as a relative risk for student athletes. Results: Among 12 schools with sufficient data available included in the final analysis, 555 372 student athlete tests and 3 482 845 nonathlete student tests were performed. There were 9 schools with decreased test positivity in student athletes compared with nonathlete students (University of Arkansas: 0.01% vs 3.52%; University of Minnesota: 0.63% vs 5.96%; Penn State University: 0.74% vs 6.58%; Clemson University: 0.40% vs 1.88%; University of Louisville: 0.75% vs 3.05%; Purdue University: 0.79% vs 2.97%; University of Michigan: 0.40% vs 1.12%; University of Illinois: 0.17% vs 0.40%; University of Virginia: 0.64% vs 1.04%) (P < .001 for each). The median (range) test positivity in these 9 schools was 0.46% (0.01%-0.79%) for student athletes and 1.04% (0.40%-6.58%) for nonathlete students. In 1 school, test positivity was increased in the student athlete group (Stanford University: 0.20% vs 0.05%; P < .001). Overall, there were 2425 positive tests (0.44%) among student athletes and 30 567 positive tests (0.88%) among nonathlete students, for a relative risk of 0.50 (95% CI, 0.48-0.52; P < .001). There was no statistically significant difference in student athlete test positivity between included schools; however, test positivity among nonathlete students varied considerably between institutions, ranging from 133 of 271 862 tests (0.05%) at Stanford University to 2129 of 32 336 tests (6.58%) at Penn State University. Conclusions and relevance: This study found that in the setting of SARS-CoV-2 transmission mitigation protocols implemented by the NCAA, participation in intercollegiate athletics was not associated with increased SARS-CoV-2 test positivity. This finding suggests that collegiate athletics may be held without an associated increased risk of infection among student athletes.
MeSH term(s)	Adult ; Athletes/statistics & numerical data ; COVID-19/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; SARS-CoV-2/pathogenicity ; Sports/statistics & numerical data ; Students/statistics & numerical data ; United States/epidemiology ; Universities/statistics & numerical data ; Young Adult
Language	English
Publishing date	2022-02-01
Publishing country	United States
Document type	Comparative Study ; Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2021.47805
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Article ; Online: Prevalence of Positive Rapid Antigen Tests After 7-Day Isolation Following SARS-CoV-2 Infection in College Athletes During Omicron Variant Predominance.

Tsao, Jessica / Kussman, Andrea / Segovia, Nicole A / Abrams, Geoffrey D / Boehm, Alexandria B / Hwang, Calvin E

JAMA network open

2022 Volume 5, Issue 10, Page(s) e2237149

Abstract: Importance: The US Centers for Disease Control and Prevention shortened the recommended isolation period for SARS-CoV-2 infection from 10 days to 5 days in December 2021. It is unknown whether an individual with the infection may still have a positive ... ...

Abstract	Importance: The US Centers for Disease Control and Prevention shortened the recommended isolation period for SARS-CoV-2 infection from 10 days to 5 days in December 2021. It is unknown whether an individual with the infection may still have a positive result to a rapid antigen test and potentially be contagious at the end of this shortened isolation period. Objective: To estimate the proportion of individuals with SARS-CoV-2 infection whose rapid antigen test is still positive starting 7 days postdiagnosis. Design, setting, and participants: This case series analyzed student athletes at a National Collegiate Athletic Association Division I university campus who tested positive for SARS-CoV-2 between January 3 and May 6, 2022. Individuals underwent rapid antigen testing starting 7 days postdiagnosis to determine whether they could end their isolation period. Exposures: Rapid antigen testing 7 days after testing positive for SARS-CoV-2. Main outcomes and measures: Rapid antigen test results, symptom status, and SARS-CoV-2 variant identification via campus wastewater analysis. Results: A total of 264 student athletes (140 [53%] female; mean [SD] age, 20.1 [1.2] years; range, 18-25 years) representing 268 infections (177 [66%] symptomatic, 91 [34%] asymptomatic) were included in the study. Of the 248 infections in individuals who did a day 7 test, 67 (27%; 95% CI, 21%-33%) tests were still positive. Patients with symptomatic infections were significantly more likely to test positive on day 7 vs those who were asymptomatic (35%; 95% CI, 28%-43% vs 11%; 95% CI, 5%-18%; P < .001). Patients with the BA.2 variant were also significantly more likely to test positive on day 7 compared with those with the BA.1 variant (40%; 95% CI, 29%-51% vs 21%; 95% CI, 15%-27%; P = .007). Conclusions and relevance: In this case series, rapid antigen tests remained positive in 27% of the individuals after 7 days of isolation, suggesting that the Centers for Disease Control and Prevention-recommended 5-day isolation period may be insufficient in preventing ongoing spread of disease. Further studies are needed to determine whether these findings are present in a more heterogeneous population and in subsequent variants.
MeSH term(s)	Humans ; Female ; Young Adult ; Adult ; Male ; SARS-CoV-2 ; COVID-19/diagnosis ; COVID-19/epidemiology ; Prevalence ; Waste Water ; Athletes
Chemical Substances	Waste Water
Language	English
Publishing date	2022-10-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.37149
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Article ; Online: Accuracy of Rapid Antigen vs Reverse Transcriptase-Polymerase Chain Reaction Testing for SARS-CoV-2 Infection in College Athletes During Prevalence of the Omicron Variant.

Tsao, Jessica / Kussman, Andrea L / Costales, Cristina / Pinsky, Benjamin A / Abrams, Geoffrey D / Hwang, Calvin E

JAMA network open

2022 Volume 5, Issue 6, Page(s) e2217234

MeSH term(s)	Athletes ; COVID-19/diagnosis ; COVID-19/epidemiology ; Humans ; Prevalence ; RNA-Directed DNA Polymerase ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2/genetics
Chemical Substances	RNA-Directed DNA Polymerase (EC 2.7.7.49)
Language	English
Publishing date	2022-06-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.17234
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Article ; Online: Findings From Cardiovascular Evaluation of National Collegiate Athletic Association Division I Collegiate Student-Athletes After Asymptomatic or Mildly Symptomatic SARS-CoV-2 Infection.

Hwang, Calvin E / Kussman, Andrea / Christle, Jeffrey W / Froelicher, Victor / Wheeler, Matthew T / Moneghetti, Kegan J

Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine

2021 Volume 32, Issue 2, Page(s) 103–107

Abstract: Objective: The risk of myocardial damage after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been controversial. The purpose of this study is to report the incidence of abnormal cardiovascular findings in National Collegiate ...

Abstract	Objective: The risk of myocardial damage after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been controversial. The purpose of this study is to report the incidence of abnormal cardiovascular findings in National Collegiate Athletic Association (NCAA) Division I student-athletes with a history of SARS-CoV-2 infection. Design: This is a case series of student-athletes with SARS-CoV-2 infection and their subsequent cardiac work-up, including troponin level, electrocardiogram, and echocardiogram. Additional testing was ordered as clinically indicated. Setting: This study was conducted at a single NCAA Division I institution. Participants: Student-athletes were included if they tested positive for SARS-CoV-2 by PCR or antibody testing [immunoglobulin G (IgG)] from April 15, 2020 to October 31, 2020. Intervention: Cardiac testing was conducted as part of postinfection screening. Main outcome measures: This study was designed to quantify abnormal cardiovascular screening results and cardiac diagnoses after SARS-CoV-2 infection in Division I collegiate athletes. Results: Fifty-five student-athletes tested positive for SARS-CoV-2. Of these, 14 (26%) had a positive IgG and 41 (74%) had a positive PCR test. Eight abnormal cardiovascular screening evaluations necessitated further testing including cardiac magnetic resonance imaging (cMRI). Two athletes received new cardiac diagnoses, one probable early cardiomyopathy and one pericarditis, whereas the remaining 6 had normal cMRIs. Conclusions: These data support recent publications which recommend the de-escalation of cardiovascular testing such as cardiac MRI or echocardiogram for athletes who have recovered from asymptomatic or mildly symptomatic SARS-CoV-2 infection. Continued follow-up of these athletes for sequelae of SARS-CoV-2 is critical.
MeSH term(s)	Athletes ; COVID-19/diagnosis ; Humans ; SARS-CoV-2 ; Sports ; Students
Language	English
Publishing date	2021-06-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1062530-6
ISSN	1536-3724 ; 1050-642X
ISSN (online)	1536-3724
ISSN	1050-642X
DOI	10.1097/JSM.0000000000000954
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