Medicine and Health Sciences Commons^™

Fos Expression In Lateral Hypothalamus/Perifornical Area Is Correlated With Psychosocial Stress-Induced Cocaine-Seeking Behavior In A Sex-Specific Manner, Milena Sudarikov, Nicole M. Hinds, Ireneusz D. Wojtas, Desta M. Pulley, Daniel F. Manvich

Rowan-Virtua Research Day

Cocaine Use Disorder persists as a significant public health concern in the United States. Recent epidemiological data indicate that rates of cocaine-involved overdose deaths are rising, and treatment of Cocaine Use Disorder is challenging due to a lack of FDA-approved medications to help patients achieve abstinence and avoid relapse. Stress can precipitate cocaine craving and trigger relapse episodes, however the underlying neural circuitry by which stressors drive cocaine seeking is not completely understood. Our laboratory has recently identified the potential involvement of the rostrolateral aspect of the periaqueductal gray (rlPAG) in psychosocial stress-induced cocaine-seeking behavior using a rodent model of …

Bridging Gaps In Opioid Use Disorder Treatment: Prehospital And Emergency Department Interventions, Quin W. Buob, Zachary J. Noll

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Since 2011, drug overdose has been the leading cause of accidental death in the United States, with two-thirds of these deaths related to opioid drugs. In 2020, the CDC reported an increase of over 91,000 overdose-related deaths. Also, non-fatal overdoses face a 5.5% one-year mortality rate post discharge, with a significant portion subsequently overdosing within 48 hours.

Access to Buprenorphine/Medication-Assisted Treatment (MAT) has been instrumental in reducing opioid-related mortality by over two-thirds, yet treatment initiation remains significantly low. Limited access stems from socioeconomic disparities and insufficient substance use treatment resources.

Emergency departments (EDs) have pioneered Buprenorphine inductions, showcasing variable success …

Evaluating The Prevalence Of Postpartum Substance Use In South Jersey, Hebba Ahmad, Joanna Petrides

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The goal of this study was to evaluate the prevalence of substance use among women who experience postpartum depression. Looking at South Jersey women in particular, we aimed to compare the rates of women who began to engage in substance use after undergoing labor within the past one year who are covered by private health insurance versus those with Medicaid coverage. A retrospective chart review was performed, and although the small sample size limited our attempts at data analysis, it revealed that there is work to be done in this field. There needs to be methods in reducing the stigma …

A Preliminary Report On The Role Of Lipoxin A4 In Reinstating The Blood-Brain Barrier Integrity In A Rodent Model Of Acute Inflammation With Impaired Cerebrovasculature, Minjal Patel, Shruti Varshney, Ananya Nethikunta, George G. Godsey, Mary C. Kosciuk, Ana Rodriguez, Bernd Spur, Kingsley Yin, Randel L. Swanson, Venkat Venkataraman, Robert G. Nagele, Nimish Acharya

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Background: The blood-brain barrier (BBB) is responsible for maintaining brain homeostasis and ultimately proper neuronal function. Disruption of the BBB, leading to increased BBB permeability, has been reported in several neurodegenerative diseases, including Alzheimer’s disease (AD) and traumatic brain injury (TBI). Lipoxins (LXs) are a class of arachidonate-derived eicosanoids, which are a class of specialized pro-resolving lipid mediators (SPMs). SPMs are known to inhibit immune response through inhibition of cellular infiltration, downregulation of pro-inflammatory mediators and upregulation of anti-inflammatory mediators. Hence, LXs are recognized as “breaking signals” in the inflammatory process. One form of LXs, Lipoxin A4 (LXA4) …

Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov

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Ms. R, a 32-year-old Hispanic female, suffers from severe anxiety exacerbated by a car accident and past struggles with depression and substance use. Evaluation reveals hypothyroidism, mild anemia, and GAD as the primary diagnosis. Factors contributing to her condition include genetic predispositions, medical issues, and social stressors. Treatment involves pharmacotherapy, psychotherapy, and monitoring her physiological health. Research on wearable data for GAD severity offers potential insights for her treatment. A holistic approach, considering biological, psychological, and social factors, guides her tailored treatment plan for overall well-being.

Efficacy Of Psilocybin In The Treatment Of Substance And Alcohol Use Disorders, Hanna Brancaccio

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Introduction: Substance use disorder (SUD) and alcohol use disorder (AUD) are major public health crises, affecting millions of Americans. Current treatment options include behavioral therapies and medications. In this review, we explored psilocybin’s efficacy in treating SUD and AUD.

Methods: Key terms were used to search databases to identify articles that addressed psilocybin in the treatment of SUD. Included in the review were indexed, peer-reviewed, primary sources that were published within the last 10 years. Excluded studies were non-peer reviewed, not relevant to the thesis, and did not have an English translation.

Results: The psychodynamic antidepressant effects of psilocybin mark …

Facial Skincare Routine Adherence In The General Population, Leah Cliatt, Joanna Petrides

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Background: The COVID-19 pandemic sparked an interest in skincare with the closure of spas and salons. “Skincare”, one of the most popular dermatology related hashtags on TikTok in July 2020 received 378 million views. The American Academy of Dermatology (AAD) has shared facial cleansing recommendations; however, it is unclear how many people follow them. Studies have shown a good daily facial cleansing and moisturizing routine can increase microbiome diversity and skin hydration. This can be beneficial in conditions like psoriasis, eczema, and acne.

Purpose: The aim of the study is to assess how well people follow the AAD …

Fregoli Case Report, Don D. Shamilov, David F. Lo, Gaurav Kumar

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Fregoli Syndrome is a rare delusional disorder in the psychotic spectrum named after Italian actor Leopoldo Fregoli. Existing reports focus on clinical aspects and standard treatments, leaving gaps in understanding complexity and tailored interventions. This case report contributes comprehensive analysis of a young adult male with Fregoli syndrome and emphasizes interplay of psychopathology, neurocognition, and psychosocial factors. This report highlights a holistic approach, including differential diagnosis and psychosocial dynamics and aims to improve diagnostic considerations and personalized treatment strategies for better patient outcomes.

Clinical Outcomes For Impella Patients Associated With Hyperlipidemia: An Analysis Of The National Inpatient Sample, Tony Elias, Sonika Vatsa, Kyrillos Gamal, Taha Syed, Rafail Beshai

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The Impella, a ventricular assist device, is crucial for managing severe heart failure and cardiogenic shock. Despite its widespread use, there's scant information on how hyperlipidemia affects Impella patients. To address this gap, we delved into the National Inpatient Sample Database from 2019 and 2020. Our aim was to scrutinize in-hospital outcomes among these patients. We identified 8233 Impella patients, among whom 1012 (12.3%) had hyperlipidemia. Those with hyperlipidemia displayed higher rates of hypertension, diabetes mellitus, and chronic kidney disease compared to their counterparts without hyperlipidemia. Shockingly, in-hospital mortality was notably elevated in the hyperlipidemia group, emphasizing its clinical significance. …

Barriers To Healthcare Access Between English And Spanish Speakers In An Underserved Population, Adeena Javed, Dale Johnson, Gerardo J. Rivera-Colón, Nathaniel J. Byrnes, Kristin Bertsch, Anne C. Jones

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• According to the NJ State Department of Health, Atlantic County has higher rates of smoking, respiratory disease, hypercholesterolemia, as well as death rates due to coronary heart disease, HIV, and all cancers compared to the NJ state average1,2.

• With over 20% of Atlantic County's population identifying as Hispanic, Spanish speakers encounter greater obstacles compared to their English-speaking counterparts in accessing healthcare services and improving health outcomes1,2 .

• Existing research indicates that various factors, including health insurance coverage, proximity to healthcare facilities, transportation options, health literacy levels, and trust in the medical profession, significantly influence access to healthcare …

Barriers In Obtaining A Naloxone Co-Prescription For Patients Who Are Prescribed Opioids For Pain Management, Sonika Vatsa

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As the prevalence of chronic pain rises, the number of patients prescribed opioids is increasing. Consequently, the rate of opioid overdose has increased, becoming a public health concern.For these reasons, the Center for Disease Control and Prevention recommended co-prescribing naloxone, a medicine that reverses the effects of opioid overdose.While this medication can be lifesaving, it is not accessible or available to everyone in need of it. A systematic review of existing literature pertaining to the barriers in patients receiving naloxone was conducted to evaluate the major obstacles in patients receiving a naloxone co-prescription. The results show that the major deterrents …

The Effects Of Circadian Misalignment On Astrocyte Morphology In The Nucleus Tractus Solitarius, Kush C. Patel, Mina Shenouda, Diana Martinez

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Circadian misalignment, as experienced by shift workers, was found to increase the number of astrocytes in the nucleus tractus solitarius (nTS) - a brain region crucial for autonomic control of blood pressure. Sprague Dawley rats subjected to a 6-hour light-dark phase delay every 2 days to simulate shift work exhibited a significant increase in astrocyte cell bodies compared to control rats, both at 9am and 9pm timepoints. The increase in astrocytes may lead to greater glutamate uptake, reducing extracellular glutamate levels in the nTS. Decreased glutamatergic neurotransmission in this region has been linked to the development of hypertension. These findings …

Clinical Outcomes For Impella Procedure In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Sonika Vatsa, Kyrillos Girgis, Michael Valderrama, Rafail Beshai

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The Impella, a vital ventricular assist device, has seen extensive use in managing severe heart failure and cardiogenic shock. However, the impact of this procedure on older individuals remains poorly understood. To address this gap, we scrutinized the National Inpatient Sample Database from 2019 to 2020 to elucidate in-hospital outcomes among older patients who underwent the Impella procedure. Among the 8233 patients who underwent Impella insertion, 1389 (16.8%) were in the older population, aged 80 years or older. This subgroup exhibited a higher prevalence of comorbidities such as hypertension, diabetes mellitus, and chronic kidney disease compared to younger patients. Alarmingly, …

How Does Schizophrenia Affect The Expression Of Alpha 7 Nicotinic Acetylcholine Receptors In The Brain?, Shruti Varshney, Nimish Acharya

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Schizophrenia (SZ) is a psychiatric disorder with a pathophysiology that has not yet been fully understood. This mental illness is characterized by disruptions in cognition, social activity, affect, and perception, and affects approximately 0.085% of individuals worldwide. The Alpha 7 Nicotinic Acetylcholine Receptor (α7nAChR) has been connected to auditory function gating deficits. The purpose of this review is to understand the current literature in how the levels of α7nAChR expression and function are affected by SZ, information that could be used to develop therapies to modulate auditory hallucinations in patients with SZ. A literature search was conducted for peer-reviewed journal …

Transcranial Electrical Stimulation As A Treatment For Aging-Related Cognitive Disorders: Review Of Published Evidence, Srujan Dadi, Kyle Jackson, Don Shamilov

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Alzheimer's disease (AD) and MCI are a major concern in modern neuropsychiatric care, chiefly for their difficult management. This strategic literature review categorizes MCI via the Jak-Bondi criteria and relates it to tES treatment paradigms. Commonly used outcome measures and regional brain mapping data synergizes associations between MCI pathology and potential tES treatment targets. Effect sizes were calculated and attributed to outcome measures based on primary articles evaluating the efficacy of tES. These were then corresponded to a desired Jack-Bondi classification. A better understanding of the efficacy of tES on specific brain regions in synergy with diagnostic criteria will allow …

The Neuroprotective Role Of Lipoxin A4 In Reinstating Blood Brain Barrier Integrity In Neuroinflammatory Disease Processes, Minjal Patel, Nimish Acharya

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Background: The blood-brain barrier (BBB), formed by the vascular endothelium, astrocytic foot processes, pericytes, is a highly selective barrier that is responsible for maintaining brain homeostasis and ultimately proper neuronal function. Disruption of the BBB, leading to increased BBB permeability, has been reported in several neurodegenerative diseases, including Alzheimer’s disease (AD) and traumatic brain injury (TBI).¹ Loss of BBB integrity leads to the proliferation of pro-inflammatory cytokines, including TNFɑ, IL-1β, and IL-6.² Moderate inflammation has a beneficial response in the system following an acute injury. However, prolonged inflammation has been known to perturb homeostasis and have …

Alpha 7 Nicotinic Acetylcholine Receptor Expression In The Hippocampus Of Patients With Schizophrenia, Shruti Varshney, Ananya Nethikunta, Minjal Patel, Mary Kosciuk, Randel L. Swanson, Venkat Venkataraman, Robert Nagele, Eric Goldwaser, Nimish Acharya

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Background: Schizophrenia (SZ) is a heterogenous psychiatric condition characterized by disruptions in cognition, social activity, affect, and perception often associated with a varied combination of positive and negative symptoms. The pathophysiology behind SZ remains poorly elucidated. Earlier reports have cited the importance of the alpha 7 nicotinic acetylcholine receptors (α7nAChR) in the hippocampus and the receptor’s association with auditory sensory gating and cognitive function. Specifically, variations in the expression and functionality of α7nAChR can be linked to auditory hallucinations experienced by patients with SZ and several therapies have been researched that target α7nAChRs. However, there are very few primary research …

The Impact Of Traumatic Brain Injury On Noradrenergic Innervation Of The Prefrontal Cortex, Jil P. Modi, Christopher P. Knapp, Rachel L. Navarra

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Traumatic Brain Injury (TBI) is a common cause of death and disability in the United States, and it can occur due to varied reasons including motor vehicle accidents, gunshot wounds, and falls. Following TBIs, patients are often left with lifelong disabilities and cognitive problems that can lead to increased risk-taking behaviors. The main goal of my research was to understand the neural mechanisms that drive increased risk-taking behaviors due to TBIs. The specific areas of the brain I was interested in looking at were the medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), and/or anterior cingulate cortex (ACC) of the prefrontal …

A Brief Overview Of Food Insecurity In Southern New Jersey, Lisa Ting Huang, Krisha Darji, Jariatou Diallo, Amin Abdul Khan

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Atlantic County, located off the Jersey Shore, faces the highest level of food insecurity in New Jersey, with a rate of 11.2% as of 2021, surpassing the state's overall rate of 8.8%. This situation contributes to health issues such as hypertension, diabetes, and heart disease.

The objective of this research is to understand and address the persistence of food insecurity in Atlantic County. Community stakeholders and local physicians were interviewed to identify barriers and disparities contributing to food insecurity.

Methods included a literature review using keywords like "food insecurity" and "southern New Jersey". Proposed interventions suggest collaboration with health centers …

The Effect Of Medically Tailored Meal Program Length On Malnutrition Risk, Kaitlyn Ann Bartholomew, Jule Anne Henstenburg, Adrian Glass Crafford

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Introduction: The Metropolitan Area Neighborhood Nutrition Alliance (MANNA) provides medically tailored meals (MTMs) to individuals in the Philadelphia area with nutritional risk and chronic illness (cancers, renal disease, heart disease, diabetes, HIV/AIDS). Registered dietitians prescribe 3 or 6 months of MTMs depending on risk severity. This study investigates the impact of MTM prescription length on malnutrition risk.

Methods: Demographic, health, and program enrollment data for clients who received ≥2 months of MTMs and completed the intake and follow-up Malnutrition Screening Tool (MST) from 2020-2022 were extracted from client records and entered in REDCap. Paired t-tests and chi-square tests were used …

Spot The Signs - Comunicación Es Lo Más Importante, Daniel Rios, Victoria Wong Murray, Alexus Weatherspoon, Amy Palen, Kenneth W. Stagliano, Stephen M. Scheinthal

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Opiate overdose is an unfortunately common risk factor for suicide; suicide attempts accounted for an estimated 30% of fatal opioid overdoses during the pandemic. As a result, the Rowan School of Osteopathic Medicine Department of Psychiatry developed an Integrated Mental Health Awareness and Suicide Prevention program targeted at members of the community and frontline workers to increase awareness and provide brief interventions, which demonstrated an improvement of 89% in our English-speaking attendees.

Spanish is the most common non-English language in New Jersey, with an estimated 1.3 million speakers. Hispanic patients also frequently experience culturally bound stigmas, so it is vital …

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Neoadjuvant Versus Adjuvant Therapy For Stage Iiib-Iiid Melanoma, Bhumik Patel, Sangnya Upadhyaya

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The treatment landscape for advanced stage melanoma is rapidly evolving due to advancements in our understanding of melanoma biology and the emergence of novel therapies. This necessitates a comprehensive review to guide clinicians in adopting evidence based and patient centric approaches to treat stage IIIB-IIID melanoma. A literature review was conducted to synthesize current information on the most optimal treatment available. Data available from different clinical trials found that neoadjuvant therapy was a more effective treatment compared to adjuvant therapies alone. Furthermore, neoadjuvant therapy with combination therapy was more efficacious in producing a complete pathological response compared to monotherapy. A …

Spot The Signs- 防范未然，及时干预- 培训, Kenny Kah-Keng Leng, Victoria Wong Murray, Alexus Weatherspoon, Amy Palen, Kenneth W. Stagliano, Stephen M. Scheinthal

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Opiate overdose is an unfortunately common risk factor for suicide; suicide attempts accounted for an estimated 30% of fatal opioid overdoses during the pandemic, and patients with an episode of opiate overdose were at an 18 times higher risk of suicide in the following year. As a result, the Rowan School of Osteopathic Medicine Department of Psychiatry developed an Integrated Mental Health Awareness and Suicide Prevention program targeted at members of the community and frontline workers to increase awareness and provide brief interventions, which demonstrated an improvement of 89% in our English-speaking attendees.

Chinese is the second-most common non-English language …

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Trichotillomania Case Report, Kimberly Kluglein, David F. Lo, Don D. Shamilov

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Trichotillomania is a psycho-dermatologic disorder involving self-inflicted hair loss through pulling. Often complicated by anxiety and depression. Multifactorial etiology and limited evidence-based treatment options makes management difficult. Treatment approaches include a combination of pharmacotherapy, CBT, HRT, and ACT. Case presentation involves a 24-year-old female, diagnosed with treatment-resistant trichotillomania who achieved remission and hair regrowth through mindset reframing, physical barriers, and community support. Novel approaches focusing on mindset and community support can yield positive outcomes.

Ultrasound Versus Radiography For Evaluating Surgical Necrotizing Enterocolitis, Sayed H. Aftab, Santiago Martinez-Correa, Minh-Huy Huynh, Wondwossen T. Lerebo, Jorge Delgado, Rebecca Denis, Misun Hwang

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Purpose:

Necrotizing enterocolitis (NEC) is an abdominal inflammatory condition that is common in premature neonates. Although abdominal radiograph (AR) remains the imaging standard for NEC, it may miss up to 50% of early signs of NEC and has been described to have a sensitivity as low as 15.4% for detecting pneumoperitoneum. Abdominal ultrasound (US) is portable, non-invasive, and allows real-time bowel integrity, movement, and perfusion assessment. We aim to evaluate the concordance between US and AR in detecting NEC features and the diagnostic performance of both modalities in detecting pneumoperitoneum.

Methods and materials:

We conducted an IRB-approved retrospective, cross-sectional, single-center …

Moving On Up: A Case Study Of Hiv And Covid-Induced Guillain-Barre Syndrome, Victoria Wong Murray, Rebecca Chae, Isobel Moyer, Cindy Hou

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COVID and HIV are both common diseases, with COVID affecting an estimated 775 million and HIV affecting 39 million people worldwide. Guillain-Barre is a rare but feared complication of immune stimulation in which the body generates autoantibodies against gangliosides, found in the nodes of Ranvier, in the myelin, and in the ganglia; causing ascending paralysis.

A mid-30s man with HIV maintained on Genvoya presented to the Jefferson Health New Jersey Early Intervention Program clinic with fatigue, fever, cough, and congestion and tested positive for SARS-CoV-2 on the following day. Two weeks later, he presented to the emergency department complaining of …

Addressing The Black Maternal Mortality Rate, Kennedy Sanders, Venkateswar Venkataraman, Kate Whelihan

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Introduction: As of 2021, the Black maternal mortality rate in the United States was 69.9 deaths per 100,000 live births as compared to the national average of 32.9 and the White American average of 26.61. It has been demonstrated that this discrepancy is not fully explained by socioeconomic status. Doulas are professionals who provide support and guidance throughout pregnancy, birth, and early parenthood. Encouraging the use of doulas may be an effective approach to improve the birth experience for Black mothers. Methods: A literature review was performed using PubMed and the following search strings: maternal mortality rate (+race, +race +ethnicity, …

Ketamine Crisis: Case Report On The Complications Of Ketamine Usage And Its Rise In The United States, Shika Veera, Vajreshwari Shivaprakash Md

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The recreational use of ketamine poses various health risks, including addiction, cognitive impairments, and physical harm.

The patient is a 24-year-old female who presented with 30 lbs. unintentional weight loss, generalized weakness, and urinary incontinence over four months. She endorses right upper quadrant and suprapubic pain with occasional gross hematuria. The patient denied recreational drug use. Urine drug screen was negative. Gynecologic exam and STI testing were without concerns. On exam, she had positive right lower quadrant tenderness, suprapubic tenderness, and costovertebral angle tenderness bilaterally. The patient was admitted to the ICU due to weakness and significant hyponatremia at 115. …

Colorblind Racial Attitudes And Emotion Dysregulation: Impact On White People’S Ethnocultural Empathy And Feelings Towards People Of Color, Vanessa L. Veltre, Alissa Hochman

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Colorblind racial attitudes, which minimize the importance of race, have been identified as a barrier to understanding systemic racism and fostering empathy towards people of color (POC). This study aimed to examine the relationship between emotion dysregulation and White people's ethnocultural empathy and warmth towards people of color, and to explore the potential moderating role of colorblind racial attitudes.

The study utilized data from 511 White participants (ages 19-50) who completed the Difficulties in Emotion Regulation Scale (DERS), Colorblind Racial Attitudes Scale (CoBRAS), Scale of Ethnocultural Empathy (SEE), and a feeling thermometer scale measuring warmth towards POC. Participants were categorized …

Pituitary Adenoma Presenting As Cranial Nerve Iii Palsy And Hemifacial Pain, Yoona Choe, Justin George, Matthew Boyle, Peter Maduka

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Pituitary adenomas are common neoplasms arising from the pituitary adenohypophyseal cell. They can be classified by cell type, size and as nonfunctioning or functioning based on the secretion of pituitary hormones. Of these, approximately 48% are macroadenomas (>10 mm) and approximately 53% are prolactinomas. For how common these adenomas are, only 1 of 1100 persons manifest clinical symptoms¹ rendering detection and clinical management challenging.

Non-functioning adenomas are slow growing like most pituitary adenomas and are usually detected due to their mass effect on neighboring structures.² The majority of the reported symptoms as a results of these mass …