Southern Medical Journal最新文献

{"title":"Antibody-Drug Conjugates in the Management of Breast Cancer.","authors":"Sangeetha Isaac, Sameer Batoo","doi":"10.14423/SMJ.0000000000001885","DOIUrl":"10.14423/SMJ.0000000000001885","url":null,"abstract":"<p><p>Breast cancer remains a predominant contributor to global cancer-related morbidity and mortality among women, with its incidence steadily rising and presenting complex therapeutic challenges. Conventional treatment modalities, including chemotherapy, endocrine therapy, and molecularly targeted interventions, have demonstrated substantial clinical efficacy. The emergence of therapeutic resistance, systemic cytotoxicity, and metastatic progression continues to impede optimal treatment outcomes, however. Antibody-drug conjugates (ADCs) represent an advanced class of targeted therapeutics engineered to deliver cytotoxic agents selectively to malignant cells, thereby augmenting antitumor efficacy while mitigating off-target toxicities. This review provides a comprehensive analysis of the molecular mechanisms underpinning ADC activity, evaluates the current clinical landscape, and examines the inherent challenges in ADC-based breast cancer therapy. In addition, it discusses the clinical utility of Food and Drug Administration approved ADCs, ongoing clinical trials, and prospective advancements in ADC development.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"123-127"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancement of a Vertically Integrated Training Program (VITP): Introspective Assessment and Expansion.","authors":"Logan Hitchcock, Timothy Pitts, Rebecca Stoltz, Allyson Halbach, Jeffrey Behling, Greyson Fox Tran, Donald J DiPette","doi":"10.14423/SMJ.0000000000001941","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001941","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"137-139"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Florida Pediatric Gun Safety: Policy Recommendations and Ways Forward.","authors":"Myron L Rolle, S Hassan A Akbari","doi":"10.14423/SMJ.0000000000001939","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001939","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"128-129"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased Maternal Weight Gain in Pregnancy Is Seen with Buprenorphine Medication-Assisted Treatment.","authors":"Kara Weishaar, Nicole Lewis, Olivia Knoll, Lori Moore, Martin Olsen","doi":"10.14423/SMJ.0000000000001943","DOIUrl":"10.14423/SMJ.0000000000001943","url":null,"abstract":"<p><strong>Objectives: </strong>Medication-assisted treatment (MAT) is associated with low maternal weight gain, and low maternal weight gain is associated with infant mortality. Many MAT patients also are smokers. This study investigates buprenorphine administration during pregnancy as a possible independent risk factor for low maternal weight gain. To our knowledge, this is the first study that compares pregnant buprenorphine patients with both smoking and nonsmoking pregnant control groups.</p><p><strong>Methods: </strong>Our institution offers a combined MAT and prenatal care program for pregnant patients with opioid use disorder. With institutional review board approval, we retrospectively studied four groups of pregnant patients: very-low-dose (University) MAT, 83 patients; standard dose (community) MAT, 77 patients; smokers not taking MAT, 75 patients; and nonsmokers also not taking MAT, 167 patients. Informed consent was waived by the institutional review board, and standard methods were employed to maintain confidentiality. Exclusion criteria were body mass index greater than 30 at onset of care or inability to document body mass index, preterm delivery, incomplete data, intrauterine fetal demise or fetal anomaly, late prenatal care, polysubstance use, and maternal medical comorbidities.</p><p><strong>Results: </strong>An analysis of variance of 402 patients showed that women using buprenorphine gained less weight than women not using buprenorphine (<i>P</i> = 0.021). Although the very-low-dose group gained more weight (average 24.92 lb) compared with the standard-dose group (average 21.34 lb), the difference was not significant. The difference between the very-low-dose buprenorphine group and the nonsmoking, nonbuprenorphine group, as well as between the standard-dose buprenorphine group and the nonsmoking, non-buprenorphine group also were statistically significant.</p><p><strong>Conclusions: </strong>Buprenorphine MAT may be an independent risk factor for decreased maternal weight gain. Given this association of maternal MAT with low birth weight, further research could explore potential advantages of nutritional supplementation for pregnant patients undergoing MAT at risk for the delivery of low-birth-weight infants.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"109-112"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When a Pandemic Challenges the Art of Medicine.","authors":"Zachary M Harris","doi":"10.14423/SMJ.0000000000001940","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001940","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"155-156"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering the Community Health Worker Role in the Stroke Continuum of Care: Development of the Florida Stroke Registry CHW Stroke Training Program.","authors":"Esmeralda Segura, Farya Fakoori, Christina Ampie, Valarie Butler, Carolina M Gutierrez, Lisa Hamilton Schueler, Hannah Gardener, Victor Del Brutto, Gerard Job, Olveen Carrasquillo, Lauri Bishop, Erika Marulanda, Negar Asdaghi, Tatjana Rundek, Jose G Romano, Gillian Gordon Perue","doi":"10.14423/SMJ.0000000000001947","DOIUrl":"10.14423/SMJ.0000000000001947","url":null,"abstract":"<p><strong>Objectives: </strong>Community health workers (CHWs) help patients navigate community resources and support healthier lifestyles. Although stroke transitions of care require navigating complex clinical services and behavioral changes, there is no established formal training for CHWs in stroke care across Florida. We describe the impact of a comprehensive stroke training course designed and tailored for community health workers.</p><p><strong>Methods: </strong>We developed a CHW stroke care curriculum with input from the Florida CHW Coalition, vascular neurologists, epidemiologists, and Florida Stroke Registry stakeholders. The course, featuring a 12-credit continuing medical education curriculum, was a hybrid of live and recorded lectures, modules, and community engagement exercises. Free registrations were promoted via the Florida CHW Coalition advertisements, Florida Stroke Registry Web site and listserv, and stakeholder meetings.</p><p><strong>Results: </strong>Three separate cohorts accomplished the course. Across 3 years (2022-2024), a total of 75 participants (54 of whom completed the course) were included in this analysis. The median age was 44 years (interquartile range 35-54), with 74% of participants aged 54 years or younger. The racial/ethnic distribution was 33% Hispanic, 30% White, and 26% Black. The majority were female (n = 50, 93%). The mean pretraining score was 72% (standard deviation 15.2%), which increased to 91% (standard deviation 6.2%) posttraining. Due to the nonnormal distribution of score differences, we used the Wilcoxon signed-rank test (S) which confirmed a statistically significant improvement in scores post training (S = 735.5, p < 0.001) indicating higher post-training scores and reduced variability, indicating both effectiveness and consistency of learning gains.</p><p><strong>Conclusions: </strong>The formal training of CHWs to recognize stroke risk factors, promote self-management, and support stroke care equipped CHWs with the essential skills and knowledge to confidently foster meaningful partnerships with the community aimed at improving stroke outcomes.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"140-145"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexually Transmitted Infection Screening and Positivity in Pregnant Women Living in Areas with High Social Vulnerability Indices.","authors":"Gweneth B Lazenby, Jeffrey E Korte, Ekatrina Pekar, John L Pearce, Karley Dutra, Nina Mascia, Bethany Bruno, Jessica Pittman, Anna B Cope","doi":"10.14423/SMJ.0000000000001944","DOIUrl":"10.14423/SMJ.0000000000001944","url":null,"abstract":"<p><strong>Objectives: </strong>Pregnant women living in rural areas of the United States are not equitably served by healthcare systems and may be disproportionately affected by sexually transmitted infections (STIs). We examined the impact of location of pregnancy care on STI screening and positivity in a statewide health system.</p><p><strong>Methods: </strong>Pregnant women seeking care within a statewide health system during 2021-2022 were categorized by location of care at either the main university hospital (urban) or regional (rural) hospitals. We assessed STI screening and positivity for chlamydia, gonorrhea, and trichomoniasis within each setting and by the Social Vulnerability Index (SVI) assigned to the person's census tract (high ≥0.75 vs low <0.75). We identified 12,921 unique pregnancy episodes: 9051 (70%) within the university hospital and 3870 (30%) in regional hospitals.</p><p><strong>Results: </strong>The mean census tract SVI among all women was 0.54 (standard deviation 0.29), and 29% of pregnant women resided in areas with a high SVI. Women in care at a regional hospital were more likely to reside in areas with a high SVI compared with the university hospital (41% v. 23%). In total, 75% of pregnant women were screened for any STI (9727/12,921). Compared with university hospitals, STI screening rates during pregnancy were lower (77% vs 70%) and STI positivity during pregnancy was higher in regional hospitals (chlamydia [3.9% vs 6.4%], gonorrhea [0.6% vs 1.3%], and trichomoniasis [4.6% vs 8%]).</p><p><strong>Conclusions: </strong>In a statewide health system, pregnancy care provided in rural regional hospitals was associated with lower STI screening rates and higher STI positivity.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"113-118"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could High Game Volume over a Shorter Season Increase Noncontact Knee Injury Risk among Kentucky High School Girls' Basketball Players?","authors":"John Nyland, Ryan Modlinski, Ryan Krupp","doi":"10.14423/SMJ.0000000000001942","DOIUrl":"10.14423/SMJ.0000000000001942","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;A retrospective review of high school, college, and professional female basketball team game number and season duration comparisons was performed. The objective was to compare group differences with consideration of the possible relationship between game volume per season duration and noncontact anterior cruciate ligament injury risk from accumulated microtrauma. The study hypothesis was that the professional women's basketball team would display the most rigorous game schedule.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;For the 2024-2025 playing seasons, the top 10 high school girls' basketball teams in the state of Kentucky, 10 university or college women's basketball teams in the state of Kentucky, and 10 Women's National Basketball Association professional teams were compared for number of players on the roster, number of regular season games, season duration, frequency of two games per week, frequency of three or more games per week, total games, and average number of games per week.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Professional athletes played two games per week (mean 14.4, 95% confidence interval [CI] 13.6-15.2 weeks) more frequently than high school (mean 11.6, 95% CI 10.8-12.4 weeks) and university-college athletes (mean 12.4, 95% CI 11.8-13.0 weeks, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Professional athletes played three or more games per week (mean 7.6, 95% CI 6.8-8.4 weeks) more frequently than university-college (mean 2.0, 95% CI 1.0-3.0 weeks) and high school athletes (mean 5.4, 95% CI 4.5-6.3 weeks; &lt;i&gt;P&lt;/i&gt; &lt; 0.002), and high school athletes played three or more games per week more frequently than university-college athletes (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). Teams had comparable roster sizes (&lt;i&gt;P&lt;/i&gt; = 0.10). Professional athletes played more games per season (mean 40, 95% CI 40-40) than university-college (mean 30.2, 95% CI 29.3-31.1, &lt;i&gt;P&lt;/i&gt; = 0.028) and high school (mean 28.5, 95% CI 27.1, 27.1, 29.9; &lt;i&gt;P&lt;/i&gt; &lt; 0.001) athletes. Professional (mean 2.4, 95% CI 2.3-2.6) and high school (mean 2.4, 95% CI 2.2-2.6) athletes played more games per week than university-college athletes (mean 1.9, 95% CI 1.8-1.97; &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Professional athletes also played more games per week than university-college athletes (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). Professional athletes (mean 44.9, 95% CI 42.3-47.5) played more total games/season than high school (mean 33.7, 95% CI 32.0-35.4; &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and university-college (mean 32.4, 95% CI 31.4-33.4; &lt;i&gt;P&lt;/i&gt; &lt; 0.001) athletes. Season duration was shorter for high school athletes (mean 14.1, 95% CI 13.3-14.9 weeks) than for university-college (mean 17.1, 95% CI 16.2-18.0 weeks) and professional (mean 18.0, 95% CI 18-18 weeks; &lt;i&gt;P&lt;/i&gt; &lt; 0.001) athletes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The combination of high game volume over a shorter season duration may put high school girls' basketball players at particularly high risk for mechanical fatigue-related anterior cruciate ligament injury from noncontact mechanis","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"119-122"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploration of Alcohol Withdrawal Protocols, with a Focus on the Use of Phenobarbital.","authors":"Amy Suhotliv, Veronika Blinder, Amira Mohamed, Daniel G Fein, Ari Moskowitz","doi":"10.14423/SMJ.0000000000001938","DOIUrl":"10.14423/SMJ.0000000000001938","url":null,"abstract":"<p><strong>Objective: </strong>Severe alcohol withdrawal (SAW) is a common cause of hospital admission in the United States. There has been increased interest in phenobarbital use for SAW treatment. We aimed to investigate variability in alcohol withdrawal management protocols at different hospitals within a geographic region, with a focus on phenobarbital use.</p><p><strong>Methods: </strong>We e-mailed a survey to intensive care unit physician leadership to all New York City acute care hospitals as well as large acute care hospitals in Massachusetts regarding their protocols for SAW.</p><p><strong>Results: </strong>Of 13 respondents, eight have SAW protocols, six of whom have a distinct phenobarbital protocol. Phenobarbital load locations were in the emergency department or intensive care unit. Loading doses ranged from 8 to 15 mg/kg. Three protocols recommended an oral/intramuscular phenobarbital taper, and two protocols specified as needed phenobarbital rescue doses on hospital wards. There was some overlap in other rescue medications, but frequency and dose were not specified. Only two respondents of the survey included benzodiazepines as a rescue medication option.</p><p><strong>Conclusions: </strong>There is some evidence that phenobarbital use for SAW has comparable to improved efficacy in certain patient outcomes. It appears that current evidence may have led to the adoption of phenobarbital use in SAW protocols in several urban university hospitals. Our results demonstrate, however, that there is significant irregularity in dosing, tapers, and concomitant benzodiazepine use. Phenobarbital protocols for SAW are common among large urban hospitals, but protocols are not standardized. More research and interhospital collaboration should be undertaken to reduce variability and optimize treatment protocols.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"152-154"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Autonomy in Pediatric Trainees: Independent Rounding on a Pediatric Hospital Medicine Service.","authors":"Kathryn Leyens, Erin Cummings, Eleanor Sharp, Benjamin Miller, Alexandra Mieczkowski, Allison Rometo, John Szymusiak","doi":"10.14423/SMJ.0000000000001945","DOIUrl":"10.14423/SMJ.0000000000001945","url":null,"abstract":"<p><strong>Objective: </strong>Trainee autonomy is a value emphasized by formal governing bodies within graduate medical education, yet prior data demonstrate that pediatric residents perceive less autonomy than attendings report providing. Independent rounding (IR) is one practice that has been demonstrated in qualitative studies to promote autonomy. The objective of our study was to promote graduated trainee autonomy and to understand the interprofessional perspectives on the implementation of IR across various domains.</p><p><strong>Methods: </strong>A single-center mixed-methods study was conducted between July 2021 and June 2022 at a quaternary children's hospital. IR was introduced on one inpatient team 1 day/week for the academic year. Postsurveys were sent to participants that included resident trainees, medical students, attendings, and nurses comparing IR with traditional rounding.</p><p><strong>Results: </strong>Attendings and trainees who rotated on one of the inpatient pediatrics teams were automatically enrolled in this study, which included 26 medical students, 41 interns, 22 senior residents, and 15 attending physicians. IR was well received among all participants. All senior residents reported improved perceptions of autonomy. There was overall improved or lack of change in perceptions of patient safety, teaching and feedback, and clinical workflow. All attendings and trainees endorsed that residents should have the opportunity to round independently, with trainees feeling that the opportunity should be more frequent than once per week.</p><p><strong>Conclusions: </strong>IR is a feasible and well-received method of promoting graduated trainee autonomy.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"130-136"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}