Diagnosis Commons^™

Complications Of Fitz-Hugh-Curtis Syndrome In A Teenage Female: A Case Presentation, Marina Cugliari, Trupti Pandit

Rowan-Virtua Research Day

Fitz-Hugh-Curtis Syndrome is a manifestation of Pelvic Inflammatory Disease (PID) associated with Chlamydia trachomatis infections and less frequently with Neisseria gonorrhea.

PID affects sexually active women (15-30 years old) and accounts for 750,000 cases each year.

The case presented illustrates a female who presented with a small bowel obstruction and appendicitis, who was incidentally found to have Fitz-Hugh-Curtis Syndrome on laparoscopic exam.

Appendiceal Diverticulum Masquerading As Acute Appendicitis, Aesha Patel, Asad Abbas, Ratul Bhattacharyya, Dana Galaktionova

Rowan-Virtua Research Day

Appendiceal diverticula present as rare clinical findings and are most often confused with acute appendicitis due to similar presentation. The incidence in such cases is reported at a rate no greater than 1%.

We present a rare case of a 65-year-old female treated for acute appendicitis who was instead found to have acute sequelae of appendiceal diverticulosis.

When Are Inpatient And Emergency Dermatology Consultations Appropriate?, Hershel Dobkin, Timothy Blackwell, Robin Ashinoff

Rowan-Virtua Research Day

Hospitalists and emergency physicians continue to struggle with the assessment of dermatologic conditions, often consulting dermatology whenever a patient has a “rash” or skin concern. Dermatology is still not emphasized in medical education and often is taught to most medical students in an abbreviated fashion, which results in physicians feeling ill-equipped to deal with any dermatologic condition—either mundane or potentially life-threatening.

Better guidelines are needed for physicians in the ED and on inpatient units to guide them on appropriate use of dermatologic consultation outside the ambulatory office and the clinic. We constructed a consultation flowchart to help guide the triage …

Distinguishing Multiple System Atrophy Vs Parkinson’S Disease In An African American Woman, Mahoua Kane, Rebecca Smith, Venkat Venkataraman

Rowan-Virtua Research Day

An 87-year-old African American woman with a past medical history of atrial fibrillation on warfarin and peripheral neuropathy with a family history of myasthenia gravis presented to the Emergency Department. The primary reason was loss of consciousness upon standing. The patient was given the diagnosis of hypertension, cervical spinal stenosis, and Parkinson’s Disease. There is little improvement with medications for any of these conditions. Currently, patient has episodes of worsening BP, blackouts, dysphagia, snoring, decreasing voice pitch with trismus. In addition, the patient is positive for dizziness, mild resting tremor in left hand with rigidity, constipation, multiple UTIs and postural …

An Interesting Case Of Factitious Disorder Superimposed On Self: Factitious Disorder Vs Somatic Symptom Disorder, Michaela Margolis, Logan Noone, Jessica Baaklini

Rowan-Virtua Research Day

Factitious disorder superimposed on self (FDIS) was first described in 1951by Richard Asher, who associated the disorder with Baron Munchhausen, who narrated unrealistic and exaggerated stories about his life.

Suspicion for FDIS should be raised when patients with atypical presentations of medical disorders seek excessive use of healthcare services despite ongoing lack of clinical evidence. Patients with FDIS often demand hospitalization for their symptoms, leading to unnecessary tests and treatments. These patients show signs of pathological lying, deceitfulness, are obstinate with medical staff, and display erratic behavior. When medical investigation does not support their symptoms, patients often develop new “symptoms” …

A Puzzling Case Of Normal Pressure Hydrocephalus In The Outpatient Setting, Shadi Shams, Asim Shafique, Marym Khan, James Bailey

Rowan-Virtua Research Day

Normal Pressure Hydrocephalus (NPH) is a disease of adulthood characterized by the triad of gait disturbance, dementia, and urinary incontinence. Since NPH shares a lot of characteristics with other disorders including neurodegenerative disorders and degenerative-dystrophic spine, it is usually underdiagnosed and undertreated. Combination of ventriculomegaly seen on a computerized tomography (CT) scan or magnetic resonance imaging (MRI) with clinical findings could be used in diagnosis of NPH. However, improvement of symptoms post spinal tap procedure would be a better indication of diagnosis. Currently, shunt placement is the best available modality of treatment for NPH. Here we present a case of …

Bells Palsy: A Late Complication Of Sars-Cov-2 Infection, Rohan Umrani, Sameer Akhtar, Sean Coulson, Brian Thomas, Yvette Wang

Rowan-Virtua Research Day

A 60 year old male with a PMH of SARS-CoV-2, OSA and primary hypogonadism presented with a chief complaint of left sided facial numbness and weakness.

Bells Palsy is commonly caused by HSV, VZV, Lyme disease and less commonly ischemia or local compression. It presents with facial paralysis and loss of taste in anterior 2/3 of tongue.

In the absence of definitive Lyme serologies despite history of tick bite, it is likely that this patient had Bell’s Palsy as a late manifestation of COVID-19.

Nanoparticles For Biomedical Applications, Joseph Kim

Dissertations & Theses (Open Access)

This thesis presents development and evaluation of the potential of three new nanoparticles for biomedical applications. With the rapid growth of the field of nanoscience, researchers have explored developing nanoparticles for various biomedical applications, including imaging, therapy, and drug delivery. This thesis demonstrates the development of two C­₆₀ fullerene based nanoparticles and one boron based nanoparticle to answer key questions related to their biological potential.

In the first part of the thesis, we describe synthesis and characterization of a pure boron nanoparticle containing asolectin phospholipid-based liposome construct prepared using a water-in-oil emulsion method, as a novel alternative agent for …

Locked Nucleic Acid Aptamer And 10 Nm Gold Nanoparticles Increases The Sensitivity Of A Prion Protein Detection Assay, Haley Channell

Chancellor’s Honors Program Projects

No abstract provided.

Increasing Colorectal Cancer Screening Adherence: A Scoping Review, Megan E. Billingsley Bsn, Rn, Tiameria T. Ford Bsn, Rn, Mikayla E. Vican Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Rates have steadily increased in recent years due to high rates of obesity, smoking, and sedentary lifestyles. Screening for the disease can lead to early detection and reduced morbidity/mortality, yet screening rates remain low. Existing literature is extensive in discussing methods to increase CRCS adherence; therefore, a scoping review allows for increased understanding of barriers to CRCS and how to address those barriers to increase screening compliance.

Methods A literature search was completed from September 2020 to October 2021. Multiple databases were used, including …

Using Machine Learning To Recognize Chronic Rhinosinusitis, Irene Liu '23

Student Publications & Research

Chronic Rhinosinusitis (CRS) is a nasal disease characterized by the inflammation of the mucosa and paranasal sinuses with a duration of at least 12 consecutive weeks. So, to diagnose CRS, one needs to keep a record of their symptoms for ~12 weeks before they are recommended to get a tomography which will allow physicians to classify them as a patient with CRS or without. This is a timely and costly process; thus, machine learning should be used to speed the process up. Since patients with CRS have more obstructed noses, the sound produced should be different than an individual without …

Failure Of Passive Transfer In Camel Calves: 4 Cases (2010-2019), Amanda James, Joseph Smith, Julie Sheldon, Ricardo Videla

Faculty Publications and Other Works -- Large Animal Clinical Sciences

Failure of passive transfer is a management concern for all ruminant species, but is not well described in the literature for camel calves. This case series presents four camel calves (Camelus dromedarius and Camelus bactrianus) referred to a North American veterinary teaching hospital for diagnosis and management of failure of passive transfer. Diagnostics utilized included hematology, serum biochemistry, and immunologic methods as described for crias. Management included antimicrobial, anti-inflammatory, and plasma transfusion therapies. Three of the four calves survived to discharge, and common diagnostic practices such as evaluation of total solids, total protein, immunoglobulin G, and sodium sulfite appear to …

Identification Of Dna Methylation Episignatures For Classification And Phenotype/Genotype Correlation In Mendelian Neurodevelopmental Disorders, John Reilly

Electronic Thesis and Dissertation Repository

ABSTRACT: Diagnosis for neurodevelopmental disorders poses numerous challenges, related to the lack of specific findings and limited understanding of clinical impact of the majority of genetic variation. Epigenomics mechanisms involve chemical modifications in DNA that involve a range of cellular mechanisms. DNA methylation is an epigenetic mechanism involving addition and removal of methyl groups to cytosine residues. These methylation signals form episignatures; patterns of methylation that can be used as biomarkers capable of differentiating neurodevelopmental disorders. EpiSigns have enabled molecular diagnosis of a number of genetic conditions, classification of variants of unknown significance, and provided insights into the pathophysiology of …

Stroke Network Of Wisconsin (Snow) Scale Predicts Large Vessel Occlusion Stroke In The Prehospital Setting, Kessarin Panichpisal, Sarah Erpenbeck, Paul Vilar, Reji P. Babygirija, Maharaj Singh, M. Riccardo Colella, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: In previous trials, the Stroke Network of Wisconsin (SNOW) scale accurately predicted large vessel occlusion (LVO) stroke in the hospital setting. This study evaluated SNOW scale performance in the prehospital setting and its ability to predict LVO or distal medium vessel occlusion (DMVO) in patients suspected of having acute ischemic stroke (AIS), a scenario in which transport time to an endovascular treatment-capable facility (ECSC) is critical.

Methods: All potential AIS patients with last-known-well time of ≤ 24 hours were assessed by Milwaukee County Emergency Medical Services for LVO using SNOW. Patients with a positive SNOW score were transferred to …

Impact Of Spontaneous Breathing Trials On Reducing Ventilator-Associated Pneumonia In Adult Intubated Patients: A Scoping Review, Jireh R. Johnson Bsn, Rn, Hamzha Aysheh Bsn, Rn, Keianna Luckett Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background For ventilated patients in the intensive care unit, ventilator-associated pneumonia (VAP) is a major source of morbidity. It is difficult to diagnose due to many of the diagnostic criteria being subjective, its clinical signs that are broad, and its association with various respiratory disorders. Hospitals have developed varying ventilator bundles in expectation to prevent the incidence of Ventilator-associate pneumonia. We performed scoping review to determine the impact of spontaneous breathing trials (SBT) on reducing VAP.

Methods From August to November of 2021, using the MEDLINE, ScienceDirect, and Scopus databases and MeSH search terms, we identified over 20,000 articles containing …

Machine Learning In Healthcare: Improving The Diagnosis Of Pulmonary Embolism In Covid-19 Patients, Soheb Osmani

Undergraduate Honors Theses

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created new challenges for clinicians diagnosing pulmonary embolism (PE). Clinicians currently rely on D-Dimer levels in conjunction with clinical prediction scores to rule out and diagnose PE. However, patients with COVID-19 (the disease caused by SARS-CoV-2) often present with elevated D-Dimer levels. D-Dimer levels in COVID-19 patients have been found to be positively correlated with the severity of disease. Symptoms of COVID-19 also often align with symptoms of PE. Therefore, it becomes more difficult for clinicians to identify which COVID-19 positive patients should undergo further testing for PE. This study evaluates …

Comparison Of Survival Rates Between Two Cardiopulmonary Resuscitation Protocols And The Association Of Crew Consistency, Stacey L. Parrish, Lori Kupczynski, Pradeep Vanguri

Internet Journal of Allied Health Sciences and Practice

Background: Cardiac arrest is a life-altering event that requires swift, coordinated actions from numerous individuals for patient survival. Although return of spontaneous circulation is the goal of every emergency medical service agency, survival rates continue to be low due to many factors. Many variables are out of direct control of emergency medical service agencies, but some, such as protocol development and personnel training, are well within their power. Purpose: The purpose of this mixed-methods study was to examine the new HP-CPR protocol implemented by a large southeastern urban fire rescue department to see if changes to existing protocol assisted, in …

Succinic Semialdehyde Dehydrogenase Deficiency (Ssadhd): Qualitative Needs Assessment For Patients With A Rare Neurological Disorder, Cassandra Bovee, Kayla Woodring

Annual Research Symposium

No abstract provided.

Open Your Eyes To 3d Imaging, Lea Al Matny Dds, Ms

The Journal of the Michigan Dental Association

This cover feature illuminates the transformative role of cone beam computed tomography (CBCT) in dental diagnostics and treatment planning. As CBCT evolves from specialized to commonplace usage, its impact on various dental specialties, including oral surgery, periodontics, orthodontics, and general dentistry, becomes apparent. The article underscores the necessity of understanding CBCT's fundamental concepts and emphasizes the importance of customized imaging protocols tailored to patients' needs. Comprehensive evaluation of CBCT scans reveals anatomical variations, aids in detecting periapical pathosis, visualizing root fractures, assessing external cervical root resorption, and contributes to airway analysis. Moreover, the article explores CBCT's expanding role beyond implant …

Cbct In Clinical Practice, Tarunjeet Pabla Bds, Dmd, Ms, Dip. Abomr, Hugo C. Campos Dds, Dmd, Mds, Dip. Abomr, Aruna Ramesh Bds, Dmd, Ms, Dip. Abomr

The Journal of the Michigan Dental Association

This feature explores the integration of Cone Beam Computed Tomography (CBCT) into dental practice, offering guidelines for best practices. Introduced in 2001, CBCT revolutionized dental radiography, impacting various clinical areas. The article emphasizes the need for clinicians to comprehend CBCT technology, its benefits, and potential risks. It delves into CBCT imaging considerations, technical parameters (Field of View, Voxel Size, Spatial and Contrast Resolution), image viewing, artifacts, machine calibration, and service. Addressing radiation dose, risks, and protection, the article outlines decision-making for 2D vs. 3D imaging. It underscores the responsibility of interpreting CBCT images, legal considerations, return on investment, and the …