ࡱ> 2417 bjbjUU .(7|7|l P$@ ` b X pf0 0P,Minutes of Amateur Rowing Association Medical Committee Meeting held on Thursday 17th March 2005 at 7.00pm at 6 Lower Mall, London W6 9DJ Present: Dr Richard Budgett (Chair) Mr Mark Edgar Dr Ian Bernstein Dr Peter Thomas Dr John Sichel Apologies: Dr Simon Owens Dr Alison McGregor Dr David Babbs Dr Annabel Howell Dr Ali Sanders Dr Nicholas Peters Dr Andrew Rice Dr Tom Jenkins 1. Matters Arising Rib Stress Fractures The discussion on rib stress fractures at the last meeting was briefly reviewed. The idea that many of these stress fractures producing positive response on bone scan may be due to a traction enthesitis pulling off part of the periosteum, so that a small amount of fluid is left under the lining of the bone, was discussed. This would help explain why some rib stress fractures recover quicker than fractures elsewhere. Action: Further research with specialist musculoskeletal radiologist needed. All Regatta Medical Head Returns No specific medical returns had been received however it was hoped that medical data would be available from reports to the Water Safety Committee. Action: Discuss with Water Safety Committee (Tom Jenkins or RB) 2. Profiling and screening Cardiac screening was discussed. The Committee felt that recognition of the importance of syncopy was more important that instituting a comprehensive screening service. Mark Edgar reported that the under 23s were screened by Tom Jenkins with a questionnaire and discussion. If there is any positive suggestion of increased risk then the athlete is referred to their GP. The problem of false positives and the statistic that 400,000 athletes need to be screened to save one life was discussed. Peter Thomas reported that FISA will be holding a coaching and medical conference on 3rd, 4th and 5th November in Istanbul. One of the topics would be profiling (especially cardiac profiling). Peter Thomas agreed to circulate the programme as soon as it is available in mid April and Committee members, including Dr Nick Peter (Cardiologist) would be encouraged to attend. The Chairman will be giving a presentation on treatment of Unexplained Underperformance at the conference and if enough members are attending the next Committee meeting will be held in Istanbul. The programme will be available on the FISA website worldrowing.com. Action: Encourage as many members and BIRO doctors as possible to attend the FISA conference to progress this debate. All The importance of a comprehensive immunisation programme was discussed under the subject of screening and prevention. It was agreed that a rower who has not had primary childhood immunisations should not be allowed to join a squad because of the danger to other team members with the loss of herd immunity (until they had been immunised). Action: Encourage vaccination and all other strategies to avoid infectious diseases. All 3. BIRO Medical Back-up Mark Edgar described the system of medical back-up with two Team doctors, Andy Franklyn-Miller and Ali Sanders, himself as co-ordinator and Ann Redgrave as Consultant. The role of the ARA Medical Committee was discussed in relation to this enlarged BRIO medical team. Action: It was decided that the Medical Committee had a separate distinct role and responsibility to the ARA and should continue meeting twice a year. 4. Injury Zone The development of this computerised medical record was discussed. It is now widely used by both BIRO and the English Institute of Sport and has been of benefit to the Team, particularly the off-line version. The Committee agreed that physiologists, dieticians and psychologists attached to the Team should be able to see the medical notes and contribute in order to ensure communication between the multidisciplinary support team. They felt that coaches should be communicated with separately, since some of the information is of a confidential medical nature. The problem of interpretation of blood results going directly to coaches and athletes was discussed. Ian Bernstein offered to review the data from Injury Zone (in an annonimised way) in order to pick up patterns of diagnosis and managements. The Committee felt this would be an excellent initiative but that another year of data should be collected to make the study worthwhile. Action: Promote development and use of Injury Zone. Facilitate review of rowing data by Ian Bernstein in one year. 5. Asian flu The threat of Asian flu to the team was discussed. It was agreed that a supply Tamiflu should be taken to cover this unlikely threat, since vaccination is not available. 6. Medical Cover with Squads at Regattas and Heads Medical cover at the forthcoming World Cup was discussed. The Committee were not aware of whether any doctor had been recruited, although John Sichel reported being approached for names of doctors to cover this event. Peter Thomas would be there but with an International Federation role. Action: Committee members were encouraged to offer support if asked. 7. Doping and Therapeutic Use Exemption Certificates The Committee again applauded the paper on Therapeutic Use Exemption Certificates by the ARA but felt this should be formally accepted by UK Sport, so that testing reflects the wishes of the Association. Under the new WADA Code, the only over the counter corticosteroid that needs a therapeutic use exemption certificate is Beconese (Beclomethasone) nasal spray. Direct communication to trialists on the subject of doping and therapeutic use exemptions should be sent when they submit their ergometer test scores before trials. The Committee felt this was particularly important since some rowers join the squad late in the season despite not taking part in trials at the beginning of the season. Action: Request formal recognition of ARA document by UK Sport Anne-Marie Phelps. Review anti-doping package sent to trialists Mark Edgar Date of next meeting: Possibly 4th November in Istanbul 2005 (to be confirmed). TVhonv     = E eij(7_mMrz0;]_H* 5H*\5\8&d)Ovghmn  & F &d P  < = ij'(7^_mMpq^;<^ ,1h. 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