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Clinical Outcomes For Cardiac Ablation In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Michael Valderrama, Rafail Beshai 2024 Rowan University

Clinical Outcomes For Cardiac Ablation In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

Background

Cardiac ablation is a therapeutic intervention aimed at correcting abnormal heart rhythms by disrupting electrical pathways in the heart, using techniques such as radiofrequency or cryoablation. Despite its effectiveness, there is a scarcity of data regarding the outcomes of cardiac ablation specifically among elderly patients. Previous studies have highlighted the complexities and challenges associated with managing cardiac arrhythmias in the elderly population, emphasizing the need for further investigation into treatment outcomes in this demographic.1,2 Therefore, this study aimed to investigate in-hospital outcomes among elderly patients who underwent cardiac ablation using data from the National Inpatient Sample (NIS) Database.

Methods …


Sex Differences In Outcomes Among Patients Who Underwent Cardiac Ablation: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Taha Syed, Rafail Beshai 2024 Rowan University

Sex Differences In Outcomes Among Patients Who Underwent Cardiac Ablation: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Taha Syed, Rafail Beshai

Rowan-Virtua Research Day

Background Cardiac ablation, encompassing radiofrequency and cryoablation modalities, is a therapeutic intervention targeting abnormal heart rhythms by disrupting electrical pathways within the heart. Despite its widespread use, research focusing on sex-specific outcomes among patients undergoing cardiac ablation remains limited. Understanding potential sex differences in treatment response and outcomes is crucial for optimizing patient care and outcomes.1,2 Therefore, this retrospective cohort study aimed to analyze the national inpatient sample database to assess in-hospital outcomes among patients undergoing cardiac ablation, specifically focusing on sex disparities.

Methods Data from the National Inpatient Sample (NIS) Database for the years 2019 and 2020 were utilized …


National Inpatient Sample Analysis: Examining Clinical Outcomes In Cardiac Ablation Patients With Hyperlipidemia, Tony Elias, Mena Elmalh, Kyrillos Girgis, Taha Syed, Rafail Beshai 2024 Rowan University

National Inpatient Sample Analysis: Examining Clinical Outcomes In Cardiac Ablation Patients With Hyperlipidemia, Tony Elias, Mena Elmalh, Kyrillos Girgis, Taha Syed, Rafail Beshai

Rowan-Virtua Research Day

Background Cardiac ablation, utilizing radiofrequency or cryoablation, is a therapeutic approach for correcting abnormal heart rhythms by disrupting specific electrical pathways within the heart. Despite the growing utilization of cardiac ablation, limited research exists on the impact of hyperlipidemia, a prevalent cardiovascular risk factor, on outcomes in patients undergoing this procedure. Previous studies underscore the importance of understanding how comorbid conditions, such as hyperlipidemia, influence the efficacy and safety of cardiac ablation.1,2 Consequently, this study aimed to leverage the national inpatient sample database to investigate in-hospital outcomes among cardiac ablation patients with hyperlipidemia.

Methods Data from the National Inpatient Sample …


Case Report: Varicella Zoster Virus Encephalitis Presenting With Monochorea, Chetna Thawani, Frank Wheeler 2024 Jefferson Health NJ

Case Report: Varicella Zoster Virus Encephalitis Presenting With Monochorea, Chetna Thawani, Frank Wheeler

Rowan-Virtua Research Day

Meningoencephalitis is a broad range of symptoms as a sequela of inflammation of the CNS system. It is a diagnosis that is often missed, especially in atypical presentations. We describe a case of HSV encephalitis that presented to the ER afebrile with atypical arm movements, most similar to a monochorea, and discuss other cases in the literature of atypical presentations of this disease.


Morel Lavallee Lesion: A Shear Fascia-Nating Soft Tissue Injury, Isaac F. Su, James A. Espinosa, Alan A. Lucerna 2024 Jefferson Health NJ

Morel Lavallee Lesion: A Shear Fascia-Nating Soft Tissue Injury, Isaac F. Su, James A. Espinosa, Alan A. Lucerna

Rowan-Virtua Research Day

Morel-Lavallée lesions (MLLs), first described by their namesake, French physician Victor-Auguste-François Morel-Lavallée, in 1863, represent a distinct category of soft-tissue degloving injuries. These injuries occur when a shearing force disrupts the connection between subcutaneous tissue and fascia, severing lymphatic vessels and capillaries, and leading to an encapsulated collection of lymph, blood, and necrotic fat. Because this space is deep and enclosed, the fluid accumulation cannot easily drain or resolve spontaneously and often an inflammatory capsule develops, further inhibiting resorption. Undiagnosed, patients go on to develop chronic pain, infection, skin necrosis, progressive neurovascular deficits, and, in severe cases, potential loss of …


Back From Baclofen: A Case Report Of Baclofen Overdose, Alexis M. Dunn, Andrew M. Vasta, James A. Espinosa, Alan Lucerna 2024 Jefferson Health NJ

Back From Baclofen: A Case Report Of Baclofen Overdose, Alexis M. Dunn, Andrew M. Vasta, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 45-year-old female who presented with intentional Baclofen overdose. The patient was lethargic and then quickly unresponsive and hypotensive, intubated by EMS in the field. By the time the patient was admitted to the Intensive Care Unit (ICU), the patient was clinically brain dead. After several days of supportive care, patient slowly, and miraculously, regained full neurologic functioning and was admitted to the Psychiatric Unit.


Use Of Point-Of-Care Ultrasound In The Diagnosis Of Postpartum Cardiomyopathy, Muhammad Noman, Frank A. Wheeler, James A. Espinosa, Alan Lucerna 2024 Jefferson Health NJ

Use Of Point-Of-Care Ultrasound In The Diagnosis Of Postpartum Cardiomyopathy, Muhammad Noman, Frank A. Wheeler, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Postpartum cardiomyopathy (PPCM), also known as peripartum cardiomyopathy is a rare form of heart failure (HF) that occurs in the late stages of pregnancy or in the early postpartum period. For it to be classified as PPCM, it must occur in the absence of another identifiable cause for HF and have left ventricular (LV) systolic dysfunction with an LV ejection fraction (LVEF) less than 45%. Here we present the case of a 46-year-old female G3P2 presented 5 days postpartum cesarean section delivery in acute respiratory distress where point of care ultrasound was used for assessment of the lungs to visualize …


Over The Counter Overdose: A Case Of Tylenol Toxicity, Swet M. Patel, James A. Espinosa, Alan Lucerna 2024 Jefferson Health NJ

Over The Counter Overdose: A Case Of Tylenol Toxicity, Swet M. Patel, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 51-year-old man presenting to the Emergency Department (ED) with suicidal ideations (SI) endorsing an intentional overdose of acetaminophen. Just as important is the clinical presentation; it is equally important to obtain a detailed history of patient's presentation leading to the ED visit when evaluating a suicide attempt. Tylenol (acetaminophen) is a common over the counter (OTC) medication available to the public. Management of Tylenol overdose follows a standard outline of things to observe and intervene on. In this case, we discuss how Tylenol overdose is managed in a clinical setting through a patient who …


Wellen’S Syndrome: An Infamous Example Of Occlusive Myocardial Infarction (Omi), J. Maxell Piraneo, Joseph Pagano, James A. Espinosa, Alan Lucerna 2024 Jefferson Health NJ

Wellen’S Syndrome: An Infamous Example Of Occlusive Myocardial Infarction (Omi), J. Maxell Piraneo, Joseph Pagano, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Wellen’s syndrome is a condition with characteristic ECG changes that can be highly specific for acute myocardial infarction involving the left anterior descending (LAD) artery. Acute myocardial infarctions are one of the leading causes of death in the developed world. Its estimated annual prevalence is nearly 3 million worldwide, with more than 1 million in the United States [1]. The importance of timely diagnosis cannot be understated. Here we describe a case of myocardial infarction secondary to LAD occlusion which presented with the atypical ECG pattern known as Wellen’s syndrome.


Case Report: Diverticulitis Involving A Meckel’S Diverticulum, Samuel M. Thalathoti, Russell A. Mordecai 2024 Jefferson Health NJ

Case Report: Diverticulitis Involving A Meckel’S Diverticulum, Samuel M. Thalathoti, Russell A. Mordecai

Rowan-Virtua Research Day

We report a case of a 65-year-old female who presented with abdominal pain and was diagnosed with diverticulitis involving a Meckel‘s Diverticulum. The differential diagnosis of abdominal pain is vast, in this age group includes, but is not limited to appendicitis, diverticulitis, cholecystitis, and small bowel obstruction. In the absence of complicated features, conservative management with oral antibiotics and close outpatient follow is advised. However, in the case of complicated diverticulitis and a rare manifestation such as a Meckel’s Diverticulum, careful management is indicated.


Case Report: Babesiosis Presenting To The Emergency Department, Daniel M. Zaayenga, Daniel A. Weeks 2024 Jefferson Health NJ

Case Report: Babesiosis Presenting To The Emergency Department, Daniel M. Zaayenga, Daniel A. Weeks

Rowan-Virtua Research Day

Babesiosis is a tick-borne illness caused by the parasitic protozoa Babesia transmitted by the Ixodes tick. Babesia infect the red blood cell of its host and requires the cell for its replication. It is a disease process that can range from asymptomatic infection to organ failure and death. This case presentation reviews a 68-year-old male who presented to the emergency department with flu like symptoms and was found to have babesiosis.


Pneumocephalus – Epidural Injection Nightmare, Mohammad A. Rattu, Frank A. Wheeler 2024 Jefferson Health NJ

Pneumocephalus – Epidural Injection Nightmare, Mohammad A. Rattu, Frank A. Wheeler

Rowan-Virtua Research Day

Pneumocephalus (pneumatocele or intracranial aerocele) is defined as the presence of air in the intracranial space and most commonly occurs after a traumatic event (most commonly head or facial injury), epidural injection, cranial surgery, However, it may also be spontaneous. Classified into simple and tension types, the presentation varies based on severity and progression. Pneumocephalus with onset less than 72 hours prior to presentation is defined as acute, in contrast to a delayed presentation greater than the given timeframe. Symptoms vary based on the amount of air that is present as well as the exact location within the cranial cavity. …


Dermoid Cyst – Presenting With Llq Abdominal Pain, Mohammad A. Rattu, James A. Espinosa 2024 Jefferson Health NJ

Dermoid Cyst – Presenting With Llq Abdominal Pain, Mohammad A. Rattu, James A. Espinosa

Rowan-Virtua Research Day

Ovarian cysts are fluid-filled structures that may be defined as simple or complex and are often discovered incidentally on imaging. Their etiology can range from physiologically normal (such as follicular or luteal cysts) to ovarian malignancies. They are more common in the reproductive years secondary to endogenous hormonal production however may also occur at any age. Simple cysts more commonly occur among all age groups; mixed cystic and solid and completely solid ovarian lesions however have rates of increased malignancy. The most independent risk factor is age; therefore, post-menopausal women should have proper follow-up secondary to this risk. Some risk …


A Case Of Hhv-6 Viral Meningitis, Mohammad A. Rattu, Wayne Tamaska 2024 Jefferson Health NJ

A Case Of Hhv-6 Viral Meningitis, Mohammad A. Rattu, Wayne Tamaska

Rowan-Virtua Research Day

Meningitis is the inflammation of the meninges and associated with abnormal cell count in the cerebrospinal fluid (CSF). The lack of bacterial growth in cultures, most commonly referred to as aseptic meningitis, is frequently caused by viruses [2]. Viruses have become more common as the prevalence of bacterial meningitis has decreased secondary to vaccination use, with viral meningitis being the most common form among countries. Viral meningitis will present with fever, headache, photophobia, neck stiffness and nausea and vomiting. Younger children however may not show any signs of meningeal irritation. Viral meningitis is usually self-limiting and with good prognosis; however, …


Brief Review: The Refeeding Syndrome, Jose Gerald Aragon, Mohammed A. Rattu, Alex Gechlik, Nicolas Coan, James A. Espinosa, Alan Lucerna 2024 Rowan University

Brief Review: The Refeeding Syndrome, Jose Gerald Aragon, Mohammed A. Rattu, Alex Gechlik, Nicolas Coan, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Here we briefly review the definition, epidemiology, pathophysiology, clinical risk scenarios, prevention and treatment of the refeeding syndrome. Refeeding syndrome is a condition which arises when a severely malnourished individual has been restarted with increased nutrition in a relatively short period of time. The refeeding process can lead to shifts in a number of fluids and electrolytes. The hallmark feature is hypophosphatemia. The true incidence of refeeding syndrome is unknown. This is said to be partly due to the lack of a universally accepted definition. Populations that are likely to experience this syndrome include patients with maladaptive eating disorders, chronic …


Clostridium Perfringens Sepsis From A Hepatic Abscess With Hemolysis And Renal Failure, Requiring Hemodialysis, Joel Collins II, Katelyn Courtney, James A. Espinosa, Alan Lucerna 2024 Jefferson Health NJ

Clostridium Perfringens Sepsis From A Hepatic Abscess With Hemolysis And Renal Failure, Requiring Hemodialysis, Joel Collins Ii, Katelyn Courtney, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

The prognosis of sepsis caused by Clostridium perfringens is extremely poor, with a mortality rate of 70%-100%. Management includes antibiotic regimens specific to toxin production as well as source control via surgical or interventional mechanisms. We report a case of a 64-year-old male who presented with right upper quadrant (RUQ) abdominal pain and was diagnosed with Clostridium perfringens bacteremia with associated acalculous cholecystitis, hepatic abscess, and acute renal failure requiring hemodialysis. It is felt that early hemodialysis was an associated factor in the patient's survival.


A Systematic Review On Belimumab’S Effectiveness, Improved Health Outcomes And Quality Of Life In Patients With Lupus Syndromes, Emily Meale, Alexandra Fontaine 2024 Rowan University

A Systematic Review On Belimumab’S Effectiveness, Improved Health Outcomes And Quality Of Life In Patients With Lupus Syndromes, Emily Meale, Alexandra Fontaine

Rowan-Virtua Research Day

Autoimmune diseases are prevalent disorders that many individuals within the United States suffer from. Systemic lupus erythematosus (SLE) is a common autoimmune disease that has a high incidence in women of child-bearing age. Management for lupus depends on the anatomical location SLE manifests, the severity of disease, and the tolerance that one has for certain adverse effects. Glucocorticoids are commonly used to manage lupus. Currently, long term glucocorticoid usage is associated with devastating adverse effects, so current treatment options aim to mitigate corticosteroids use to improve quality of life while maintaining favorable health outcomes. New management for SLE include biologics …


The Effects Of Psychedelic Microdosing On Mental Health: A Systematic Review, David F. Lo, Hasan Zia, Adarsh Thakur, Praneetha Rajkumar, Don D. Shamilov 2024 Rowan University

The Effects Of Psychedelic Microdosing On Mental Health: A Systematic Review, David F. Lo, Hasan Zia, Adarsh Thakur, Praneetha Rajkumar, Don D. Shamilov

Rowan-Virtua Research Day

This poster explores the effects of psychedelic microdosing on mental health conditions. Roughly 5.5 million individuals in the U.S. utilize psychedelics to treat their mental health issues. The primary substances used for microdosing currently include LSD and psilocybin, but mescaline, DMT, and amphetamines are used less commonly. This systematic review included 16 unique articles. The types of articles included: observational, placebo, self-reported, motivational, literature review, and comparative studies. The studies indicated lower levels of anxiety, depression, and stress among those that microdose. However, drawbacks such as difficulty sleeping and headaches were reported. Various studies have been published on the effects …


Interactive Distraction Techniques Versus Midazolam In Anxiolysis In Pediatric Patients: A Systematic Review And Meta-Analysis, Uzay Cagatay, Jon Elias, Alexander King 2024 Rowan University

Interactive Distraction Techniques Versus Midazolam In Anxiolysis In Pediatric Patients: A Systematic Review And Meta-Analysis, Uzay Cagatay, Jon Elias, Alexander King

Rowan-Virtua Research Day

Background: Many pediatric patients experience high levels of anxiety prior to undergoing surgery. Midazolam is currently one of the most commonly used sedative drugs in the pediatric preoperative environment. A number of studies have evaluated the use of non-pharmacological methods of relaxing pediatric patients prior to surgery, known as ‘Interactive Distraction’. These techniques involve using various methods of distracting the child from the preoperative anesthetic procedures. Some examples of these methods involve giving the patient an iPad with which they can play video games. There have yet to be any systematic reviews comparing the usage of Midazolam alone against utilizing …


Exploring Geriatric Self Management Of Type 2 Dm: A Systematic Review, Ahmed Gawash, David F. Lo, Kunal P. Shah, Jasmine Emanuel, Brandon Goodwin, Don D. Shamilov, Gaurav Kumar, Nathan Jean, Christian P. White 2024 Rowan University

Exploring Geriatric Self Management Of Type 2 Dm: A Systematic Review, Ahmed Gawash, David F. Lo, Kunal P. Shah, Jasmine Emanuel, Brandon Goodwin, Don D. Shamilov, Gaurav Kumar, Nathan Jean, Christian P. White

Rowan-Virtua Research Day

This review explores diabetic self-management in geriatric individuals, focusing on positive attitudes and support from family/friends as crucial for self-care optimization. A comprehensive search in health databases was conducted, which involved screening 248 participants across eight qualitative research studies. Themes emphasizing the importance of listening to one’s body, acknowledging hidden issues, and recognizing the impact of various factors on diabetes self-care were established. A holistic approach to self management, emphasizing the significance of positive attitudes, cultural sensitivity, and individual values in healthcare practices is recommended. Embracing cultural diversity and addressing barriers can enhance self-management and quality of life for geriatric …


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