Medical Specialties Commons^™

Seroprevalence Of Hepatitis B And Hepatitis C In Patients Hospitalized In Palliative Care Service, Meryem Betos Koçak, Burcu Güler

Saudi Medical Journal

Objectives: Patients receiving palliative care often have complex comorbidities and frequent healthcare exposure, which may place them at risk for blood-borne infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV). However, data on the seroprevalence and prognostic impact of these infections in palliative populations remain limited. This study aimed to determine the seroprevalence of HBV and HCV markers in patients hospitalized in a palliative care unit and to assess their association with mortality. Methods: This retrospective study conducted on 545 adult patients a tertiary palliative care unit between 2018 and 2024. Demographic characteristics, comorbidities, nutritional support, mobility, …

Artificial Intelligence In Dialysis Therapies: Applications In Hemodialysis And Peritoneal Dialysis For Managing Infectious Diseases And Complications, Waleed H. Mahallawi

Saudi Medical Journal

This narrative review synthesizes evidence from a systematic literature search (2019–2025) on artificial intelligence (AI) applications in hemodialysis and peritoneal dialysis for managing infections and complications. Dialysis patients face infection rates 100-fold higher than the general population and sepsis mortality exceeding 35%. The AI, utilizing machine learning algorithms such as XGBoost, deep neural networks, and explainable AI tools, revolutionizes care through precise diagnostics, prognostics, and therapeutics. Key models demonstrate high accuracy in predicting bloodstream infections (area under the curve [AUC] 0.914), classifying peritonitis (F1 0.93), detecting SARS-CoV-2 (AUROC 0.82), and forecasting mortality (AUC 0.979). Therapeutically, AI guides antibiotic stewardship, reducing …

Post-Stroke Fatigue In Saudi Arabia: A Call To Action, Saad Z. Alqahtani

Saudi Medical Journal

Post-stroke fatigue (PSF) is a major consequence of stroke, with a prevalence of approximately 42–53% among stroke survivors. However, over the last 2 decades, only a few studies have explored PSF in Kingdom of Saudi Arabia (KSA). Findings from these studies show that PSF negatively impacts the quality of life of individuals with stroke. Furthermore, they emphasize the need for education for both health care providers and patients regarding PSF. This call-to-action mini narrative review identifies knowledge gaps and provides recommendations for both researchers and policymakers, including the need for standardized management and the exploration of hospital environment settings. Specifically, …

Contribution Of Interleukin-6 (Il-6) To Body Defense And Healing In Pulmonary Tuberculosis, Hasrah Junaidi, Annis C. Adi, Soedarsono Soedarsono, Soetjipto Soetjipto, Chatarina U. Wahyuni, Fariani Syahrul, Mahmudah Mahmudah, Zakiyuddin Zakiyuddin, Iskandar Arfan, Abdullah A. Mamun, Rubia Sari

Saudi Medical Journal

Objective: To examine the contribution of IL-6 to host defense and healing in pulmonary tuberculosis (TB). Pulmonary tuberculosis continues to pose a significant global health challenge, with disease outcomes determined by complex host–pathogen interactions. Interleukin-6 (IL-6), a multifunctional cytokine, has been implicated in immune regulation and tissue recovery during TB, but its specific role is not fully established. This review aimed to examine the contribution of IL-6 to host defense and healing in pulmonary TB. Methods: A comprehensive literature search was performed across PubMed, Scopus, Web of Science, ScienceDirect, and Medline following PRISMA guidelines, covering publications from 2015 to 2025. …

Impact Of Treatment On The Health-Related Quality Of Life Of Children With Cancer In Saudi Arabia, Fayzah Hussain Alhussain, Amany Anwar Saeed Alabdullah

Saudi Medical Journal

Objective: The impact of cancer on health-related quality of life (HRQOL) is considerable, particularly for children undergoing oncological treatment. While research has addressed HRQOL in childhood cancer survivors, less attention has been given to those actively undergoing treatment, including in Saudi Arabia. This systematic review aimed to address this gap by quantitatively evaluating studies reporting on the HRQOL of children in Saudi Arabia during their active cancer treatment phase. We also compare these findings with studies from around the world, emphasising demographic, medical and parental predictors of HRQOL. Methods: A comprehensive search of relevant databases (MEDLINE, CENTRAL, Embase, PsycINFO and …

Efficacy Of Continuous Pegcetacoplan Treatment For Subfoveal Geographic Atrophy In Age-Related Macular Degeneration: 36-Month Results From Oaks, Derby, And Gale Open-Label Extension, Dilsher S. Dhoot, Sunir J. Garg, David M. Brown, Ivan J. Suñer, Ehsan Rahimy, David S. Boyer, Kineta Naidu, Chao Li, Caroline R. Baumal, Robyn H. Guymer

Wills Eye Hospital Papers

PURPOSE: To report efficacy of intravitreal pegcetacoplan treatment over 36 months in eyes with subfoveal geographic atrophy (GA).

PATIENTS AND METHODS: The GALE (NCT04770545) open-label extension trial adds 12 months of results to the 24-month Phase 3 OAKS (NCT03525613) and DERBY (NCT03525600) trials, representing up to 36 months of continuous pegcetacoplan treatment. They included a heterogeneous population of eyes with subfoveal GA (63%). Pegcetacoplan-treated eyes enrolling in GALE continued at the same interval of pegcetacoplan monthly (PM) or every other month (PEOM). Patients' eyes in sham monthly or every-other-month arms crossed over to receive pegcetacoplan in GALE at the same …

Stimulant Medications And Bone Health, Christine M Swanson, Julie H Wolfe, Chadi A Calarge

Faculty, Staff and Students Publications

Purpose of review: This review summarizes the potential impact of stimulant medications on bone health, to raise awareness and optimize their safe use.

Recent findings: Stimulant medications can impair bone health through inadequate nutrient/calorie intake and stimulation of the sympathetic nervous system, which regulates bone metabolism. However, their use decreases fracture risk in younger populations ([Formula: see text]25 years old) with attention deficit/hyperactivity disorder (ADHD), likely through reductions in impulsivity and injury. Special care may be needed when fractures occur while using these medications, as recent data suggest psychostimulants are associated with impaired fracture healing. Prescription and non-prescription use of …

Cigarette And E-Cigarette Use In Greater Philadelphia: Proportion Of Use Compared To National Data And Local Predictors Of Smoking Status, Munjireen Sifat, Joshua Banks, Lilianna Phan, Kuang-Yi Wen, Julie A. Barta, Rebecca J. Melillo, Hee-Soon Juon

College of Population Health Faculty Papers

UNLABELLED: Objective tobacco use, cigarette, e-cigarette, cancer-related beliefs, perceived risk, lifestyle attribution, cancer disparities, health equity. We assessed cigarette smoking and e-cigarette use in the Greater Philadelphia region alongside national data. The objectives were to descriptively explore differences in tobacco use by sociodemographic characteristics. We also examined cancer belief associations with smoking and e-cigarette use in the local context.

METHODS: We descriptively compared cross-sectional survey data from 2744 adults in the Sidney Kimmel Comprehensive Cancer Center (SKCCC) catchment area (Greater Philadelphia region; May-July 2022) with 6252 Health Information National Trends Survey (HINTS 6) nationally representative respondents (United States; March-November 2022). …

Turf Toe And Sesamoid Fracture Case Study, Mason Cannon

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE This case presents the evaluation and management of a 15-year-old male multi-sport high school athlete. The athlete initially sustained a turf toe injury that progressed into a sesamoid fracture. This report showcases the clinical findings, treatment progression, and outcomes within a disablement model framework.

Prevalence Of Low Energy Availability (Lea) Risk In Division Iii Female Distance Athletes, Ciara Murphy

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE The objective of this study was to explore the prevalence of LEA among division III female distance athletes.

The Effectiveness Of An Educational Program On Young Swimmers Water Consumption And Dry Land Exercises, Maria Thibodeaux, Shelby Bay, Maddie Hoyt, Elizabeth Starns, Elizabeth Nix

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/CONTEXT Although shown to improve performance, many young swimmers are reluctant to participate in dry land exercises.¹ They are also more likely to become dehydrated than their non-swimming counterparts, suggesting they are not adequately hydrating during activity and throughout their day.² Therefore, this study aimed to evaluate the impact of a four-week educational program on dry land exercises and water consumption.

From Focal Chondral Defect To Matrix-Induced Autologous Chondrocyte Implantation In An Active Adult: A Case Study, Zoey Scott

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Present a clinical case detailing the undetermined consequential factors associated with FCD progression  in athletic populations, and the subsequent challenges.

Post-Surgical Dislocations: A Latarjet Procedure, Brianagh Dean, Kimberly S. Peer

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

BACKGROUND The glenohumeral joint is the most frequently dislocated joint in the body, with an incidence rate of 40.4 per 100,000 in men and 15.5 per 100,000 women. Recurrence rates following a first-time anterior shoulder dislocation range from 33-40%, particularly among adolescent collision-sport athletes. Arthroscopic Bankart repair is performed to address anterior instability, however recurrent instability may occur in the presence of glenoid bone loss. The Latarjet surgery is indicated in cases of recurrent anterior instability with significant bony deficiency, functioning through a triple-blocking mechanism increasing glenoid surface area via coracoid transfer, creating a dynamic sling effect from the conjoined …

Oral Contraceptives Rate Of Reduction On Anterior Cruciate Ligament Injuries In Females: A Critically Appraised Topic, Paige Trent, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO Anterior cruciate ligament (ACL) injuries occur more frequently in females than males, with estimates suggesting a 2-10 greater likelihood of females to sustain this trauma.3 FIFA issued a recent call to action encouraging further investigation into why females are still predisposed to this trauma.2 ACL incident rate is highest amongst females between 14–18-years-old with approximately 227.6 exposures per 100,000 persons per year.1 Multifactorial influences are suggested as predisposing risk factors including anatomical or hormonal components.1 Growing interest in hormonal contributions has led researchers to examine how fluctuations in estrogen, progesterone, and testosterone impact ligamentous integrity.8

Estrogen receptors are …

Case Report: Chronic Peroneal Subluxation, Natalie Weissman, Morgan Cooper Bagley, Colin Reidy

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE The case study presented explores the sign, symptoms, and unique treatment of a patient with a chronic peroneal subluxation of the right ankle. The clinical evaluation showed full range of motion with visible peroneal tendon movement over the right lateral malleolus. Surgery was not done or recommended; a four-phase rehabilitation with a return to play protocol was used. This case showed how rehabilitation through a non-surgical approach is still achievable.

The Effect Of Taper On Scapular Positioning In Division Iii Collegiate Swimmers, Maddie Hoyt, Elizabeth Starns, Andrew Busch

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Scapular asymmetry and lateral translation are prevalent in competitive swimmers due to the repetitive overhead nature of the sport.^1,2 Additionally, ambiguity exists in the reliability of non-invasive scapular assessments. First, this study aimed to compare differences in scapular positioning during the competitive swimming season to the tapered season. The tapered season is marked by a significant decrease in intensity.^3,4,5 Second, this study aimed to determine the reliability of three commonly used scapular assessments.

Anterior Cruciate Ligament Autograft Reconstruction Outcomes In Adolescents And Young Adults: A Critically Appraised Topic, Klevione D. Brown, River A. Hamilton, Elizabeth A. Starns

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO Anterior cruciate ligament (ACL) tears are one of the most common serious knee injuries seen in high school and college-aged athletes.¹ Many athletes opt for surgical reconstruction because ACL injuries often result in knee instability and impair their ability to return to play in their sport.² There are three primary types of autografts used in reconstruction: bone-patellar tendon-bone (BTB), hamstring tendon (HT), and quadriceps tendon (QT) autografts.³ It is important to determine if a graft type has better return-to-play outcomes for adolescent and young adult athletes.

Sport-Related Concussion Incidents Across Sports, Surfaces, And Injury Mechanisms: A Retrospective Analysis Of A Digital Concussion Database, Justin Belle, Jay Alberts, Jason Cruickshank, Richard Figler, Kelsey Owen, Sami Rifat

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/CONTEXT Sport-related concussion (SRC) represents a significant injury burden in youth athletics. Advances in digital injury surveillance platforms allow for large-scale clinical databases that may provide insight into injury mechanisms, sport distribution, and management patterns. The purpose of this study was to describe the distribution of concussion-related incidents across sports, playing surfaces, and mechanisms of injury using data from a prospectively maintained clinical concussion database.

Dysautonomia In Adolescent Athletes With Persistent Post‑Concussion Complaints, Jason A. Cruickshank

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/BACKGROUND Dysautonomia is dysfunction in autonomic nervous system manifesting following concussion, contributing to Persistent Post‑Concussion Complaints (PPCC).^1,5 Patients with dysautonomia may present with dizziness, tachycardia, postural intolerance, headaches, cognitive fog, and activity/exercise intolerance.^1,5 Recognition of autonomic involvement is essential to recovery and preventing prolonged symptoms^.1,5

The Effectiveness Of A Mental Health Literacy Webpage For Parents, Coaches, And Athletic Trainers, Mackenzie Warner, Kimberly Peer, Hannah Harnar, David Dees

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

INTRODUCTION Mental health illnesses continue to emerge as a major public health concern, particularly among adolescents and young adults. Secondary school student-athletes face unique pressures related to academics, athletic performance, time management, injuries, and social expectations, all of which may contribute to anxiety, depression, stress, or other mental health conditions. However, there is limited research that explores secondary school student-athletes and how mental health affects their everyday lives. This could be due to the lack of mental health literacy in the individuals who surround secondary school student-athletes, including parents, coaches, and athletic trainers. Increasing their understanding of mental health literacy …

Understanding Athletic Trainer's Knowledge And Perceptions Of Mental Health Best Practices: A Mixed-Methods Study, Chelsea Pasukinis, Yvette Ingram, Malissa Martin, Robert B. Krueger

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Mental health disorders are increasing in our society. Research on athletic trainers' (AT) knowledge and perception of mental health disorders, and whether policies are developed and used, is limited. The purpose of this study is to investigate AT’s knowledge of mental health illness, current policies and procedures, and the perceptions ATs have of mental health.

A Case Report Of Blunt Renal Trauma In A High School Football Athlete, Mariah Reeder

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/BACKGROUND Blunt abdominal trauma in football athletes is uncommon but carries significant risk for internal organ injury and hemorrhage. Although sport-related renal injuries are rare, a significant portion of them are high-grade (IV-V) and may require advanced medical intervention if not recognized promptly.¹ Symptoms may initially appear benign, such as “having the wind knocked out,” increasing the risk of delayed diagnosis. Athletic trainers often serve as first responders and play a critical role in early recognition, on-field management, and prompt referral for advanced medical care. This case highlights athletic trainer led clinical decision making and interdisciplinary coordination following blunt …

Assessment Of A Middle School Return To Learn Concussion Protocol, Aaron Yaksich, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE To evaluate the effectiveness of a newly implemented return to learn (RTL) concussion protocol in an adolescent athletic population.

Challenging The Standard: A Case Report Of Postpartum Rehabilitation Prior To Return To High-Intensity Functional Training, Aly Matejka

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Postpartum athletes frequently attempt to return to high-intensity training without graded rehabilitation of the deep core and pelvic floor complex, contributing to urinary incontinence, impaired load transfer, unresolved diastasis recti, and decreased performance capacity. Despite increasing participation of postpartum individuals in high-load functional training, there is limited applied literature outlining structured, criterion-based return-to-exercise progressions that address breathing mechanics, pelvic floor function, and force development prior to reintroduction of impact and resistance training. This case report describes the implementation of a 15-week postpartum rehabilitation and return-to-training protocol designed to restore neuromuscular control, muscular endurance and strength, and impact tolerance prior …

A Post-Professional Athletic Training Education Module For Detecting Skin Conditions In Diverse Skin Tones, Lauren Oskam, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE To develop and evaluate a learning module designed to improve athletic trainers’ proficiency in identifying skin conditions commonly acquired in the sport of wrestling across diverse skin tones.

Leveraging Multimodal Large Language Models For Fall Risk Reduction In Older Adults In The Home: Proposed Model Design, Justin Do, Vivaswat Suresh, Lily Zhang, Bharvi M. Chavre, Jeremy Cha, Robert S. Pugliese

SKMC Student Presentations and Publications

This research letter proposes a novel model design leveraging natively multimodal large language models to identify fall risks and generate visualizations of recommended home environmental modifications, aiming to improve the accessibility and impact of personalized fall prevention advice for older adults. Through a pilot rating study, this work demonstrates that multimodal large language models can generate safe and actionable advice to reduce fall risk in lived spaces of older adults, and also generate realistic edits based on original images. While this concept needs further testing and clinical comparison, it highlights a promising avenue for further innovation of fall prevention tactics.

Anatomy Of The Orbit: Radiologic And Surgical Anatomy Of Anterior And Medial Approaches, Emily Garvey, Benjamin Bitner, Mindy R. Rabinowitz

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Purpose of Review: To review relevant medial orbital anatomy as well as the most commonly used approaches to this space. Recent Findings: The use of the endoscopic endonasal approach for access to the medial orbit, including the intraconal space, has expanded allowing for removal of previously “inoperable” pathology. Summary: Each approach has their strength when considering access to the medial orbit, the transcaruncular incision allows for fast access with limited dissection while the transpalebral approach allows for visualization of the medial orbit but also extended access to the superior and lateral orbit. Conversely, the conjunctival approach allows for wider access …

A Tactile Trans-Flexor Carpi Radialis Surface Landmark Technique For Median Nerve Local Injection: A Cadaveric Study, Clark Chen, Keenan Sobol, Connor Hickey, Duncan Vannest, John Ibrahim, James Raphael

Einstein Health Papers

PURPOSE: Median nerve (MN) block under local anesthesia at the wrist is commonly performed but can be limited by anatomic variation, particularly absence of the palmaris longus tendon. This study investigates a novel trans-flexor carpi radialis (trans-FCR) technique for MN anesthesia that uses the flexor carpi radialis (FCR) tendon as a consistent surface landmark.

METHODS: Fourteen fresh frozen upper extremity cadaver specimens were used. A 25-gauge needle was inserted through the FCR sheath approximately 4 cm proximal to the wrist crease in a transverse fashion, angled approximately 0° to the vertical and parallel to the wrist crease. The trans-FCR technique …

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …