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Tarsal Tunnel Syndrome Due To Post-Traumatic Osseous Tunnel Formation: A Rare Case And Surgical Management, Dev Y. Patel, Eshan Doshi, Fiona Zimmerman, Jamal Revolus, Michael Kimball, Michael Franco

Cooper Rowan Medical Journal

Tarsal tunnel syndrome (TTS) is classically a compressive neuropathy of the posterior tibial nerve beneath the flexor retinaculum, presenting with plantar foot pain and paresthesias. Standard surgical management of TTS involves release of the flexor retinaculum to decompress the nerve. We report a rare and unusual case of TTS in which the posterior tibial nerve was encased within a post-traumatic osseous tunnel accompanied by dense fibrotic tissue, representing an atypical and previously undescribed etiology of nerve entrapment. In this case, surgical decompression required a modified approach involving meticulous dissection of the tibial nerve from its encasement by heterotopic ossification and …

Evaluating Medical Student Geriatric Competency Using A 5ms-Based Assessment Tool, Lauren R. Hersh Md, Amy Cunningham Phd, Mph, Xiya Wu Md

Cooper Rowan Medical Journal

INTRODUCTION

Driven by an aging Baby Boomer generation, the United States is navigating a demographic transformation with far-reaching implications that include increased demand for chronic disease management and long-term care as well as increased stress on both healthcare costs and infrastructure. Generating a workforce competent in the delivery of care to older patients with complex, multimorbid conditions is fundamental to addressing this shift. Recognizing that the development of primary and specialty care physicians skilled in geriatric care begins in medical school, the American Geriatric Society developed minimum competencies grounded in the Geriatric 5Ms (Mind, Mobility, Medication, Multicomplexity, and …

Plasma Vgf As A Predictive Biomarker For Early Acute Kidney Injury In Critically Ill Elderly Patients: A Combined Clinical And Mendelian Randomization Study, Xianyang Guo, Yu Hao, Rujie Chenn, Benji Wang, Shengwei Jin

Saudi Medical Journal

Objectives: To assess whether VGF nerve growth factor inducible (VGF) can serve as a reliable predictor of acute kidney injury (AKI) among patients requiring intensive care.
Methods: We first conducted a Mendelian randomization (MR) analysis to explore the potential causal link between plasma VGF levels and AKI risk. Subsequently, 128 critically ill individuals admitted to our intensive care unit were prospectively enrolled. Within 24 hours of either hospital admission or clinical decline, both blood and urine specimens were obtained. We measured VGF concentrations in plasma and urine, along with plasma cystatin C (pCysC), plasma and urinary neutrophil gelatinase-associated lipocalin (NGAL), …

Knowledge, Practice And Perceived Barriers Of Healthcare Provider Adherence To The Notifiable Disease Surveillance System (Ndss) In Government Hospitals And Primary Healthcare Centers In Jazan, Saudi Arabia: A Cross-Sectional Study, Moatasem F. Hakmi, Alaa Mathkour, Yousef Zahrani, Rayan I. Binduhayyim, Saad S. Alqahtani, Muhammad Z. Iqbal

Saudi Medical Journal

Objective: To assess and compare healthcare providers' understanding of the Notifiable Disease Surveillance System (NDSS), alongside reported and perceived challenges, across public hospitals and primary healthcare centers in Jazan, Kingdom of Saudi Arabia.
Methods: A cross-sectional study was conducted between 10 January 2025 and 30 December 2025 among health care providers at Jazan hospitals and primary healthcare centers (PHCs) (n = 420). Data were collected via structured self-administered questionnaire that included the following sections: demographic data, knowledge of the NDSS, reporting practices, competency of the Health Electronic Surveillance Network (HESN) and perceived barriers. Descriptive and inferential statistics were used to …

Cranial Mri In Girls With Central Precocious Puberty: Clinical Characteristics And Predictors Of Abnormal Findings, Fahad N. Al Juraibah, Mashael M. Alharbi, Reem D. Alharbi, Joud S. Albaraki, Sarah S. Aldharman, Hala A. Alghamdi, Nagarajkumar Yenugadhati, Abdullah I. Alhammad, Angham N. Almutair, Ibrahim A. Al Alwan

Saudi Medical Journal

Objectives: To describe the clinical profile of girls with central precocious puberty (CPP) and determine the factors associated with abnormal cranial magnetic resonance imaging (MRI) findings.
Methods: This retrospective study included girls aged 8 years or younger with a diagnosis of CPP who received care at King Abdullah Specialized Children's Hospital in Riyadh, Kingdom of Saudi Arabia, between 2015 and 2023. Data on clinical presentation, biochemical results, imaging findings, and treatment were obtained from medical records. Logistic regression analysis was performed to determine variables associated with MRI utilization and the occurrence of abnormal MRI findings.
Results: The cohort comprised 70 …

Thrombosis Rate And Risk Factors In Pediatric Patients With Peripherally Inserted Central Catheters, Ahmed A. Alabdulkarim, Abdullah I. Almojali, Tharaa S. Alhowaish, Dena S. Alsuhaibani, Norah I. Alshafi, Amin I. Alzahrani, Mohammed O. Alotaibi, Yousef A. Alghamdi, Hamad A. Alkhalaf

Saudi Medical Journal

Objective: To determine symptomatic thrombosis incidence in pediatric patients with peripherally inserted central catheters (PICCs) and identify associated patient and procedure-related risk factors in a tertiary pediatric center in Saudi Arabia.
Methods: We conducted a retrospective cohort study at King Abdullah Specialized Children's Hospital, Riyadh, Kingdom of Saudi Arabia, including patients aged 0–14 years who underwent PICC insertion in the Interventional Radiology department between January 2019 and June 2023. Data on demographics, comorbidities, procedural details, and outcomes were extracted from the electronic medical record system (BestCare). Symptomatic thrombosis was defined as Doppler-confirmed thrombosis with clinical signs. Associations were tested using …

Advancing Impact: A National Approach To Knowledge Translation In Saudi Arabia-The Saudi National Institute Of Health Experience, Maha M. Aleid, Manar A. Alharbi, Amal N. Almadouj, Ahmad I. Alrawaji, Lamia A. Alhaqbani, Fars K. Alanazi

Saudi Medical Journal

Objectives: To present a reproducible national model for translating research findings into evidence-based clinical practice guidelines.
Methods: The Saudi National Institute of Health launched the initiative titled ``Transforming the Outcomes of Published Health Research into Medical Guidelines that Enhance Medical Practices to Improve the Quality of Human Health'' on February 3, 2025. The initiative aimed to identify and assess research outcomes published between January 1, 2020, and December 31, 2024 across 6 predefined thematic tracks relevant to the Saudi population. Eligible publications were collected within one month after the submission portal opened. Following closure of portal, all submissions were evaluated …

Estimating Radiation Dose And Proposing Institutional Diagnostic Reference Levels For Paediatric Fluoroscopy Of Micturating Cystourethrogram: Age- And Weight - Specific Comparisons, Khalid M. Aloufi

Saudi Medical Journal

Objective: To compare age- and weight-specific methods used to estimate radiation doses and to propose institutional diagnostic reference levels (DRLs) for paediatric fluoroscopy of micturating cystourethrogram (MCUG).
Methods: In this retrospective study, MCUG fluoroscopy parameters were gathered for 100 paediatric patients from July 2025 to January 2026. The data included the MCUG paediatric procedures for patients aged 0–15 years. The data were categorized into paediatric weight- and age-specific groups. Paediatric weight-specific groups were ≤ 5, 5 < – 10, 10 < – 20, and >20 kg, and paediatric age-specific groups were ≤ 1, 1 < – 5, 5 < – 10, and < 10 – 15 years old.
Results: Differences were observed in dose area product (DAP) and DRL results for age- …

Potential Drug–Drug Interactions In Patients Undergoing Hemodialysis: A Retrospective Observational Study, Buthainah B. Al-Ammash, Fawaz A. Alharbi, Omar D. Al-Hejaili, Mansour A. Mahmoud, Mazin A. A. Abdelaziz, Alaa I. Alrais, Shahad A. Albakri, Ibrahim F. Alharbi, Sara A. Felemban, Abdullah H. Almatrafi, Salman A. Alabdali, Yaser M. Alahmadi

Saudi Medical Journal

Objectives: To evaluate the prevalence, characteristics, and determinants of potential drug–drug interactions (pDDIs) among patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) at a tertiary care hospital in Al-Madinah Al-Monawara, Kingdom of Saudi Arabia.
Methods: Data for this retrospective observational study were extracted from the electronic medical records of adult patients (≥ 18 years) diagnosed with ESRD and receiving hemodialysis (HD) between October 2022 and March 2023. The pDDIs were identified and classified using Lexicomp® (Wolters Kluwer, Alphen aan den Rijn, Netherlands). Descriptive statistics summarized patient characteristics and pDDIs, and univariate logistic regression was implemented to investigate the determinants …

Drooling In Children With Cerebral Palsy: A Narrative Review Of The Current Management Landscape, Kamel A. Alenazi

Saudi Medical Journal

Children with developmental or neurological disorders, such as cerebral palsy, present with impaired motor function, resulting in impaired swallowing, feeding, and drooling. The prevalence of chronic drooling radically changes from 0.5% in children >4 years to 60% in children with neurological ailments. Drooling can have a serious impact on the quality of life of affected children, which can create a sense of isolation and refusal by peers. In addition, drooling results in not only financial but also considerable emotional turmoil for caregivers of affected children, who are frequently confronted with difficulty managing the underlying neurological impairment of their child. In …

Scoping Review Of Mental Health Outcomes Of Cosmetic Procedures Among The Saudi Population, Hessah Alzahrani

Saudi Medical Journal

Objective: To comprehensively examine the mental health outcomes associated with cosmetic procedures among the Saudi population, with a particular focus on psychological well-being, self-esteem, anxiety, body image, and quality of life.
Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. A structured search was performed across international databases, including PubMed, PsycINFO, Scopus, Web of Science, and Google Scholar, in addition to national Arabic databases. Studies investigating the psychological outcomes of both surgical (rhinoplasty and body contouring) and …

Quality, Patient Experience, And Service Gaps In Home Healthcare In Saudi Arabia: A Systematic Review Aligned With Vision 2030, Eman Alawad, Rasha M. Mahrous, Lubna A. Elshaib

Saudi Medical Journal

Objectives: To assess the quality of home healthcare (HHC) services, patient experience, and existing service gaps in Kingdom of Saudi Arabia.
Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. PubMed, MEDLINE, Scopus, Web of Science, CINAHL, and Google Scholar were searched for studies published between January 2011 and January 2025. Eligible studies included observational, qualitative, mixed-methods, and interventional studies conducted in Saudi Arabia that examined home healthcare quality, patient or caregiver experience, or service delivery gaps. Two reviewers independently screened studies, extracted data, and assessed methodological quality …

Implementing Diagnosis-Related Groups For Value-Based Healthcare In Saudi Arabia: A Systematic Review Of Evidence On Barriers And Facilitators, Racha M. Naim, Michelle A. Badore, Justin J. Needle

Saudi Medical Journal

Objective: To examine the barriers and facilitators to implementing Diagnosis-related groups (DRGs) in Kingdom of Saudi Arabia, aiming to identify actionable insights for policymakers and stakeholders to advance value-based healthcare (VBHC) adoption effectively.
Methods: A systematic search of bibliographic databases and relevant grey literature was conducted. Data were synthesized using the Consolidated Framework for Implementation Research (CFIR) to categorize barriers and facilitators across 5 domains.
Results: A total of 10 studies met the eligibility criteria. Key facilitators included the adoption of patient classification systems, standardized data sets, government policy support, and the availability of advanced health information systems. Barriers included …

From Bench To Bedside: Evolving Definitions Of Translational Research, Hana A. Alhumud, Fars K. Alanazi, Edward B. Devol

Saudi Medical Journal

Objective: To synthesize current evidence on the evolution, frameworks, and methodological approaches used to define and operationalize translational research, which serves as a bridge between scientific discovery and its application in clinical medicine, public health, and policy.
Methods: We systematically searched PubMed, Scopus, and Web of Science for peer-reviewed studies published up to 2023. Search terms combined translational research–related keywords (such as ``bench-to-bedside,'' ``implementation science,'' ``precision medicine'') and relevant MeSH terms. Eligible studies focused on conceptual models, frameworks, or methodological approaches related to translational research and were published in English. After duplicate removal and PRISMA-guided screening, 33 publications were included. …

Pharmacist-Led Initiative To Increase Naloxone Prescribing For Patients On High-Dose Opioids In A General Internal Medicine Clinic, Christine E. Leduc, Hyun J. Lee, Polly D. Fraga

The Lahey Journal

Abstract

Introduction:

Opioid overdose is a pressing public health concern in the United States. In 2022, prescription opioids were involved in 15% of all opioid deaths.1 Despite CDC recommendations for prescribing naloxone to high-risk patients, primary care physicians prescribe only 1.5 naloxone prescriptions per 100 prescriptions of high-dose opioids.2,3 Strategies are needed for healthcare institutions to expand naloxone access and mitigate opioid-related harm. This pilot study assesses the impact of a pharmacist-led quality improvement patient outreach initiative on increasing naloxone prescribing for adult patients taking ≥ 50 MME per day of prescription opioids as recommended by current CDC guidelines.

Methods: …

Strengthening Health System-Community Partnerships To Address Pediatric Social Needs: A Qualitative Study, Joy Friedman, Melissa A. Alderfer, Kelsey Higgins, Aaron Carpenter, Jennifer Sciolla, Sarah E. Wawrzynski

Department of Pediatrics Faculty Papers

IntroductionStructural and social conditions influence pediatric health outcomes. Successful implementation of social needs screening and referral programs depends on community-based organizations (CBOs) to provide resources that address health-related social needs (HRSN). We explored current practices and perspectives of health care workers and CBO representatives on improving health system-CBO partnerships.MethodsParticipants were purposively recruited from a variety of health care settings involved in HRSN screening and CBOs delivering resources in the community. Participants completed semi-structured interviews. Qualitative thematic analysis was used to summarize data.ResultsTen key informants participated (six health care workers and four CBO representatives). Four themes were identified: 1) mismatches in …

Intravascular Immune Cell Labeling As A Critical Methodological Tool For Characterizing Cd4+ T Cells In The Lung In Eae, Gholamreza Azizi, Mohamad Rostami

Department of Neurology Faculty Papers

INTRODUCTION: Growing evidence highlights the lung -brain axis as a key contributor to CNS autoimmunity. However, accurate characterization of lung immune cells remains technically challenging because standard transcardial perfusion does not eliminate the lung's extensive marginated intravascular leukocyte pool, allowing circulating cells to contaminate analyses of the lung parenchyma.

METHODS: Experimental autoimmune encephalomyelitis (EAE) was induced in mice by immunization with MOG35-55 peptide in complete Freund's adjuvant, followed by pertussis toxin administration. Lung mononuclear cells were isolated after intravascular (IV) CD45 labeling, transcardial perfusion, and enzymatic digestion. Immune cell populations and intracellular cytokine production were analyzed by multicolor flow cytometry …

Gait Characteristics In Older Adults Using The Protokinetics Zeno Walkway: The Atherosclerosis Risk In Communities (Aric) Study, Katherine J. Hunzinger, Laura Skow, Andrea L. C. Schneider, Michael E. Griswold, Xiaoqian Zhu, Farwa Ali, Pamela L. Lutsey, Jennifer A. Schrack, Luigi Ferrucci, Eleanor M. Simonsick, B. Gwen Windham

Department of Exercise Science Faculty Papers

BACKGROUND: Gait speed is an important indicator of functional status and health outcomes in older adults. Electronic gait mats are common in research, but stopwatches are more feasible in clinical practice. This study compared agreement between single task (ST) gait speed measured by stopwatch and gait mat and described single and dual task (DT) gait performance measured by gait mat.

METHODS: A subset of Atherosclerosis Risk in Communities (ARIC) Study Visit 8 participants completed ST cognitive (serial subtractions), ST gait speed, and DT gait (gait with serial subtractions) on an electronic gait mat; ST gait speed was also assessed by …

Strengthening The Evidence Base For Pediatric Cardiac Ct: Statistical And Technological Considerations, Faizan Faisal

Journal of the Saudi Heart Association

No abstract provided.

Comments On The Letter: Strengthening The Evidence Base For Pediatric Cardiac Computed Tomography: Statistical And Technological Considerations, Lamia Ghazi Jamjoom, Razan Kamal Daghistani

Journal of the Saudi Heart Association

No abstract provided.

Skin Carotenoid Scores Reflect Immune Status Among Children Living With Hiv In Tanzania, Wilbert Mbuya, Thobias Boniphace, Michael Mwagala, Peter Agrea, Nazareth M Mbilinyi, Nancy E Moran, Andrew R Dinardo, Mkunde Chachage

Children’s Nutrition Research Center Staff Publications

Many individuals living with HIV experience persistent inflammation despite antiretroviral treatment, increasing their risk for cardiovascular diseases, cognitive decline, and other noncommunicable diseases. Carotenoids can inhibit this inflammation by reducing lipid peroxidation. Carotenoid intake and plasma concentrations can be approximated using a noninvasive cutaneous spectrophotometer. This study quantified skin carotenoid levels in Tanzanian children ages 5 to 15 years old (N = 185) both with and without HIV. Over 95% had low to moderate skin carotenoid scores (< 400 units). In children living with HIV, higher viral loads were linked to lower skin carotenoid scores (rho = -0.57, P < 0.001), whereas higher CD4 counts correlated with increased skin carotenoid scores (rho = 0.52, P < 0.001). Overall, carotenoid levels were low and associated with immune status, suggesting that elevated carotenoid scores correlate with lower inflammation in children living with HIV. Future studies investigating dietary carotenoid interventions to support immune function are warranted.

Diversity Among Academic Orthopaedic Surgery Sports Medicine Faculty Across Us Residency Programs, Terence L. Thomas, Alexander Zavitsanos, Claude Regis, John Czarnicki, Harrison S. Fellheimer, Gabriel I. Onor, William Justice, Jalen Broome, Damon V. Briggs, Edward S. Chang, Meghan Bishop, Christopher C. Dodson

Rothman Institute Papers

BACKGROUND: Despite growing attention to workforce diversity in orthopaedic surgery, limited data exist describing the demographic composition of academic sports medicine faculty. This study examines the diversity of sports medicine fellowship-trained orthopaedic surgery faculty across US orthopaedic surgery residency training programs.

METHODS: A cross-sectional analysis of all ACGME-accredited orthopaedic surgery sports medicine faculty was conducted. Faculty data included sex, race, level of professorship, residency attended, year of residency graduation, and h-index. Underrepresented in Orthopaedics (URiO) was defined as non-White and non-Asian by race and all women. Descriptive statistics were performed.

RESULTS: A total of 812 sports medicine-fellowship trained faculty were …

Newborn Screening Reduces Survival Disparities In Scid After Stem Cell Transplant: A Pidtc Report, Lena E Winestone, Brent R Logan, Xuerong Liu, Olatundun Williams, Elizabeth A Dunn, Monica S Thakar, Sharon A Kidd, Talal Mousallem, Morna J Dorsey, Richard J O'Reilly, Neena Kapoor, Lisa Forbes Satter, Malika Kapadia, Soma C Jyonouchi, Sharat Chandra, Christen L Ebens, Deepakbabu Chellapandian, Sonali Chaudhury, Karin Chen, Blachy J Dávila Saldaña, Ahmad Rayes, Troy C Quigg, Shanmuganathan Chandrakasan, Jeffrey J Bednarski, Kenneth B Desantes, Pierre Teira, Alfred P Gillio, Hesham Eissa, Alan P Knutsen, Victor M Aquino, Evan B Shereck, Theodore B Moore, Emi H Caywood, Mark T Vander Lugt, Jacob Rozmus, Larisa Broglie, Lolie C Yu, Ami J Shah, Avni Y Joshi, Rebecca H Buckley, Jasmeen Dara, Joseph H Oved, Hisham Abdel Azim, Caridad A Martinez, Susan Prockop, Kathleen E Sullivan, Jack J Bleesing, Michael D Keller, Lisa M Madden, Suhag Parikh, Shalini Shenoy, Christine M Seroogy, Tamar Rubin, Jennifer Licata, Jeffrey R Andolina, Donald B Kohn, Lauri Burroughs, Jennifer W Leiding, Rebecca A Marsh, Luigi D Notarangelo, Sung-Yun Pai, Troy R Torgerson, Michael A Pulsipher, Jennifer Heimall, Geoffrey D E Cuvelier, Linda M Griffith, Jennifer M Puck, Christopher C Dvorak, Morton J Cowan, Elie Haddad

Faculty, Staff and Students Publications

Black race and Hispanic ethnicity are associated with higher mortality in severe combined immunodeficiency (SCID) following hematopoietic cell transplantation (HCT), though mechanisms remain unclear. We evaluated 796 children with SCID who received nonsibling HCT between 1982 and 2020 using data from the Primary Immune Deficiency Treatment Consortium. Overall survival for Black (aHR 2.47, 95%CI 1.64, 3.71) and Asian/Pacific Islander patients (aHR 1.82, 95%CI 1.00, 3.30) was significantly lower compared with non-Hispanic White patients, while Hispanic patients had lower event-free survival (aHR 1.83, 95%CI 1.27, 2.63) compared with non-Hispanic White patients. Even after adjusting for age and infection, Black patients with …

Pola Rujukan Penyakit Saluran Pernapasan Di Fasilitas Kesehatan Tingkat Pertama: Tantangan Gatekeeper Program Jaminan Kesehatan Nasional Di Jakarta, Syarif Rahman Hasibuan, Melrose Holy Natasha, Fatih Jihadi Ramadan

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Program Jaminan Kesehatan Nasional yang diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan mewajibkan Fasilitas Kesehatan Tingkat Pertama (FKTP) untuk menyeleksi kasus yang memerlukan rujukan. Penyakit saluran pernapasan yang menjadi penyebab utama kunjungan ke FKTP memiliki pola rujukan yang masih belum banyak diteliti. Oleh karena itu, dilakukan penelitian untuk melihat pola rujukan penyakit saluran pernapasan di FKTP dan mengetahui faktor yang berasosiasi dengan keputusan rujukan. Penelitian potong lintang ini dilakukan terhadap 89.225 klaim FKTP di Jakarta pada periode 2017-2023, dengan kriteria inklusi semua kunjungan dengan diagnosis ICD-10 diseases of the respiratory system. Uji regresi logistik dilakukan untuk mengidentifikasi faktor …

Neuroimmune Phenotyping As The Next Frontier In Chronic Pain Medicine For Musculoskeletal Back Pain, Samer G. Salman, Rohan A. Phadke, Adithya Nair, Rahul Kumar, Arbaz Momin, Alireza Tavakkoli, James Rizkalla

Department of Neurosurgery Posters

Background: Chronic low back pain encompasses heterogeneous mechanical, neuropathic, nociplastic, and myofascial presentations that may reflect distinct neuroimmune mechanisms. We synthesized evidence linking these phenotypes to measurable biological features and clinically relevant treatment strategies.

Methods: We conducted a structured literature search of MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials for studies published from January 2005 through January 2025. Systematic reviews, randomized controlled trials, and mechanistic studies addressing neuroinflammation, glial activation, central sensitization, biomarkers, or imaging were organized according to four clinically relevant pain phenotypes and translational readiness.

Results: Neuroimmune findings differed across axial mechanical, …

Acute Liver Injury Likely Induced By Alpha Lipoic Acid Contained In Dietary Supplement, Simona Maksimyan, Jonathan V. Reyes, Kasim Kazbay, Farah K. Gazi

Journal of Community Hospital Internal Medicine Perspectives

The rise in use of herbal and dietary supplements, which are regulated as food rather than as drugs by the Food and Drug Association, poses the risk of unknown and potentially severe side effects. We describe the case of acute liver injury, characterized by significant elevation in AST and ALT, likely induced by the consumption of an over-the-counter supplement containing alpha lipoic acid (ALA). Our patient trusted in a “natural” alternative to Western medicine for management of neuropathy, which was ultimately detrimental to her liver. An immediate and sustained improvement in liver enzyme levels was noted with discontinuation of the …

The High Cost Of Incomplete Physical Exams: Missed Diagnosis Of Cushing Syndrome In A Patient With Recurrent Hospital Admissions, Tarah M Burton, Miranda K Hunter, Mihail Zilbermint

Journal of Community Hospital Internal Medicine Perspectives

Cushing syndrome is a rare but life-threatening endocrine disorder associated with a classic constellation of physical exam findings (e.g. “moon facies”, abdominal striae, etc.). However, thorough biochemical testing is needed to confirm this diagnosis. We present the case of a 35-year-old male with multiple hospitalizations across a variety of healthcare institutions for heart failure, cellulitis, uncontrolled hypertension, and diabetes.  While an adrenal mass was eventually identified on imaging, classic signs of Cushing syndrome – including violaceous striae, truncal obesity, and facial plethora – were missed during prior admissions.  This case illustrates the diagnostic delay that can result from incomplete physical …

Clinical And Laboratory Predictors Of 30-Day Mortality In Hiv-Positive Adults With Pneumonia: A Prospective Observational Study From North India, Mandip Singh Bhatia, Ankita Kumari Bhargav, Saurabh Chandrabhan Sharda, Shankar Naidu, M. R Shivaprakash, Sunil Sethi, Vikas Gautam, Arnab Ghosh

Journal of Community Hospital Internal Medicine Perspectives

Background: Pneumonia remains a major cause of morbidity and mortality among people living with HIV (PLHIV), particularly in low- and middle-income countries. Despite the availability of antiretroviral therapy (ART), early mortality after hospitalization for pneumonia remains high. Indian data on short-term mortality predictors in HIV-associated pneumonia are limited.

Methods: We conducted a prospective observational study of HIV-positive adults admitted with pneumonia to a tertiary-care hospital in North India between April and December 2025. Clinical, laboratory, microbiological, and radiological parameters were recorded at admission. Patients were followed for 30 days. The primary outcome was all-cause 30-day mortality. Predictors of …

Universal Screening For Measles Immunity During Pregnancy: A Cost-Effectiveness Analysis, Anuradha Devabhaktuni, Sarah Boudova, Elias Kassir, Sohum Shah, Neil S. Silverman, Christina S. Han

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Measles is a highly contagious illness capable of causing significant morbidity and mortality, including adverse pregnancy outcomes. Routine screening for measles immunity is not currently recommended during pregnancy. Given the increasing frequency of measles outbreaks nationally and globally, awareness of measles immunity status can influence management of pregnant individuals who incur measles exposures and offer an opportunity for postpartum or preconception vaccination.

OBJECTIVE: We sought to evaluate the cost-effectiveness of universal screening for measles immunity during pregnancy in the United States.

STUDY DESIGN: A decision-analytic model was constructed to evaluate the cost-effectiveness of universal screening for measles immunity during …

Prepregnancy Obesity Versus Excessive Gestational Weight Gain: A Comparative Evaluation Of Adverse Outcomes, Samuel Schultz, David Krantz, Matthew Blitz, Ashley Battarbee, Moti Gulersen

Department of Obstetrics and Gynecology Faculty Papers

Background/Objectives: Obesity and excessive gestational weight gain (EGWG) are known risk factors for adverse outcomes in pregnancy, but the comparative risk is less well defined and increasingly relevant in an era of increasing use of weight loss medications. We aimed to determine whether EGWG was associated with adverse maternal and neonatal outcomes, compared with prepregnancy obesity. Methods: Multicenter retrospective cohort study of pregnant patients who delivered a singleton within a single university health system from 2019–2024. Patients with missing prepregnancy body mass index (BMI) data, BMI < 18.5 kg/m2, or pregestational diabetes were excluded. Logistic regression with propensity score weights and g-computation were used to evaluate if the incidence of several adverse maternal and neonatal outcomes were impacted by prepregnancy obesity and gestational weight gain (GWG). p values were adjusted for multiple comparisons. Results: Among the 129,615 pregnancies included, 28,516 (22.0%) had prepregnancy obesity, 36,943 (28.5%) were overweight prior to pregnancy, and 64,156 (49.5%) had a normal BMI prior to pregnancy. When compared to patients with obesity, patients with normal prepregnancy BMI and EGWG had a lower risk of adverse maternal and neonatal outcomes, including gestational diabetes, gestational hypertension, preeclampsia, eclampsia, cesarean delivery, and postpartum hemorrhage, as well as large and small for gestational age birthweight, stillbirth, neonatal intensive care unit admission, neonatal mechanical ventilation, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and sepsis. Beneficial effects were attenuated for patients with overweight prepregnancy BMI or for larger EGWG. Conclusions: Lower prepregnancy BMI, even with the potential unintended consequence of EGWG, may be more favorable than untreated prepregnancy obesity with regard to perinatal outcomes.