Concussion Awareness Program aims to change the sports game

James Toldi, D.O., assistant professor of family medicine at the USA College of Medicine, assesses Murphy High School student-athlete Napoleon Colston as he demonstrates the tests used to diagnose concussions from the sidelines. 

USA Health has relaunched a new initiative on concussion prevention and education on the Gulf Coast. The Concussion Awareness Program has the potential to change the lives of athletes for the better by accurately and rapidly diagnosing concussions through a series of cognitive and physical assessment tests. The program is led by James Toldi, D.O., a sports family medicine physician at USA Health and assistant professor of family medicine at the University of South Alabama College of Medicine.

The program is designed to decrease the number of missed concussions and decrease the recovery process for players.

While injuries are often part of sports, some injuries can have life-long, debilitating effects. According to Toldi, a concussion is when the brain hits the skull, adding that it can be a short-lived injury that is self-resolving. However, the aftermath of a concussion could lead to more serious issues. “Post-concussion symptoms can last months or years,” Toldi said. “Some research shows repetitive head trauma or concussions can lead to health problems such as memory loss, mood changes and chronic headaches.”

Researchers at the Centers for Disease Control and Prevention add concussions can cause increased risks for brain disorders such as Alzheimer’s and Parkinson’s diseases as well as chronic traumatic encephalopathy (CTE), which research has shown to be a common brain injury in athletes.

The region’s only academic health system has partnered with the United States Sports Academy on the cognitive testing portion. “The partnership with USA Health is an exciting one that started back in 2016,” said Brandon Spradley, chair of sports management with the Sports Academy. “The program has grown to also include preseason concussion baseline testing, on-field assessment tools for athletic trainers and a concussion clinic for athletes to be evaluated.”

Six Mobile County Public Schools high schools and one private school have participated in the concussion program. “This is an opportunity for our school system to partner with USA Health and the United States Sports Academy to be proactive,” said Mobile County Public Schools’ Athletic Director Brad Lowell. “This creates more concussion awareness for our parents and players. It gives our athletes the opportunity to get the baseline tests so that if an injury occurs, we can use the data during recovery.”

The need for change in how concussions are handled sparked USA Health to join an initiative to keep athletes safer. In 2014, Anthony Martino, M.D., professor and chair of neurosurgery, and Ashley Marass, pediatric nurse practitioner, decided to participate in an educational challenge aimed at changing concussion safety. The project was created by the National Collegiate Athletic Association (NCAA) and the U.S. Department of Defense. Martino, Marass and a team at Encore Rehabilitation created an educational video, which was chosen as one of the top six in the country, to help athletes learn more about concussions. The educational portion of the program includes a pre-test, a video and a post-test to measure knowledge about concussions.

Toldi said he wanted to make the program more comprehensive. “In addition to the education piece, I wanted to add on concussion assessment tools that can be used on the sidelines when there is an injury,” he said.

Two tests are used to diagnose a concussion from the sidelines leading to the quick removal of an athlete from a game. “We chose the Sideline Concussion Assessment Tool 5 (SCAT5), which measures cognitive and physical changes and the King-Devick test, which measures eye movement and vision,” said Toldi. “The added bonus of the King-Devick test is that it has been validated when the test administrator is a medical professional or a lay person (coach, parent, athletic trainer) that is on the sideline. We could educate the athletic trainers on how to properly administer these tests without a physician required to be there.”

There are currently open appointments for athletes who have experienced sports-related concussions, to allow for proper follow-up and a plan for recovery with Toldi and staff. The appointments are every Monday on the second floor of the Strada Patient Care Center on Center Street in Mobile.

Toldi hopes to expand to more schools in Mobile and Baldwin counties and the surrounding area. “Arming trainers with the access to these tests and how to perform them is a powerful tool that could limit further injury and create a safer environment for athletes.”

Keel to discuss prostate health at October Med School Café

The October Med School Café will feature Christopher Keel, D.O., a urologist with University Urology and adjunct assistant professor of surgery at the University of South Alabama College of Medicine.

Keel will discuss prostate cancer screenings and other men's health issues. The lecture will be held Friday, Oct. 25, at the Faculty Club on USA's main campus. Lunch is served at 11:30 a.m., and the presentation begins at noon.

Keel earned his medical degree from Nova Southeastern University in Fort Lauderdale, Florida. He completed an internship in general surgery and his residency training in urology at Tulane University School of Medicine in New Orleans.

He is board certified by the American Board of Urology and is a Fellow of the American College of Surgeons.

The Med School Café lecture and lunch are provided free of charge, but reservations are required. For more information or to make reservations, contact Kim Partridge at (251) 460-7770 or email kepartridge@health.southalabama.edu.

Med School Café is a free community lecture series sponsored by USA Health. Each month, faculty and physicians share their expertise on a specific medical condition, providing insight on the latest treatment available.

The Faculty Club is located at 6348 Fincher Road.

Register Now: Southern Structural Biology Symposium set for Oct. 11

The first Southern Structural Biology Symposium will be held from 8 a.m. to 4 p.m. Oct. 11, in the USA Health Mitchell Cancer Institute Multipurpose Room.

Sylvie Doublié, Ph.D., professor of microbiology and molecular genetics at the University of Vermont, will present the keynote lecture.

Breakfast and lunch will be provided. The meeting is sponsored by Bruker.

RSVP to Aishwarya Prakash, Ph.D., assistant professor of biochemistry, at aprakash@health.southalabama.edu.

Second-year medical student completes surgery research, wins research award

Medical student Corey Phillis studied the prevalence of scurvy in surgical patients. She is shown with her mentors, Madhuri Mulekar, Ph.D., left, and William Richards, M.D.

Corey Phillis, a second-year student at the University of South Alabama College of Medicine, was one of the 2019 recipients of the University of South Alabama College of Medicine Clyde G. Huggins Award for Summer Research given as part of the 46th Summer Medical Student Research Program.

Phillis’ presentation was titled “Prevalence of Scurvy in Surgical Patients” and was sponsored by William Richards, M.D., professor and chair of surgery at the USA College of Medicine. She also worked closely with Madhuri Mulekar, Ph.D., professor and chair of mathematics and statistics at USA.

“Research is at the core of what we do here at USA Health, and I enjoy working with our medical students on these projects as it gives them insight into improving patient care by examining complex issues,” Richards said. “Corey’s research gave us a better picture of the prevalence of vitamin deficiencies in candidates for surgical treatment and highlighted potential preoperative screenings that may improve patient outcomes.”

During the USA College of Medicine Summer Research Program, students spent eight weeks completing research and working on their project and poster presentation for research day. Phillis’ project looked at how common vitamin C deficiency is in surgical patients at USA Health University Hospital. She reviewed the charts of approximately 440 patients who had a vitamin C level ordered starting in 2015 and looked for any deficiencies and any comorbidities the patients possessed. The data was then analyzed by Mulekar to see which values were statistically significant.

According to Phillis, one of the most notable findings from the data was the overall prevalence of scurvy in the surgical patient population – 53 percent were deficient in vitamin C. Another interesting finding from the research was that 44 percent of patients who presented at the hospital with a first-time hernia also showed a vitamin C deficiency. Through this, they concluded that all patients presenting with a hernia should have their vitamin C level checked to determine if supplementation should be given before elective surgery.

“Research is a fundamental part of medicine and the driving force on the progression of the field,” Phillis said. “Surgery has been a specialty I always found myself considering, so I wanted to find a research project this past summer that would help me explore it further. Working with Dr. Richards helped me do just that. I was able to work alongside older medical students, interns, residents, and attendings and got a good feel of what the field is like.”

Phillis is originally from Anniston, Alabama, and earned her undergraduate degree from the University of Alabama. She chose to attend USA for medical school because of the small class sizes. “I really liked the idea of a class environment where both students and faculty support student success,” she said.

The University of South Alabama College of Medicine Clyde G. Huggins Award for Summer Research honors the memory of Clyde G. "Sid" Huggins who served as the first dean of students for the USA College of Medicine.

Student-Run Free Clinic wins grant from CVS Health Foundation

The University of South Alabama Student-Run Free Clinic plans to purchase an Automated External Defibrillator thanks to a $1,000 grant from the CVS Health Foundation.

The CVS Health Foundation Volunteer Challenge Grant was awarded in support of the Individual Volunteerism work of CVS Health employee and Auburn University pharmacy student Willie Dunnam, according to the award letter from the foundation. The clinic is housed at The Salvation Army of Coastal Alabama on Dauphin Street in Mobile.

“We not only feel like the AED is an important tool to have in our clinic but also an important tool for The Salvation Army,” said Alison Rudd, Ed.D., clinic operations director and assistant director of the USA Simulation Program. “This is just a continued reflection of not only our service to our patients, but our partnership with a wonderful community agency.”

Dunnam, who served as the clinic’s community outreach coordinator in 2018, and third-year medical student Ravi Rajendra, co-president of the clinic, were instrumental in obtaining the grant, Rudd said. As community outreach coordinator, Dunnam helped set up the clinic’s involvement in Project Homeless Connect.

“While working with Willie Dunnam on several clinic projects, I realized that one of our biggest strengths at USA SRFC is our interdisciplinary format,” Rajendra said. “Though we may come from different health professions and though our skill sets may vary, we all have the desire to help heal our patients.”

The mindset of encouraging partnerships between healthcare professionals was the impetus for applying for the grant, he said. On any given day at the clinic, the student team could consist of future physicians, pharmacists, physician assistants, nurses, audiologists, occupational therapists, physical therapists and social workers.

“Since our backgrounds vary, we’re able to solve problems from different angles and spend more time with patients to help explain common health conditions,” he said. “Finally, SRFC allows us to learn not only from each other, but also from our patients.”