Digital Commons Network^™

Igg4-Related Autoimmune Pancreatitis In Patients With Prior Occupational Exposure: A Case Report And Review Of Risks Concerning Blue-Collared Workers, Zachary A. Coren, Justin Le, Jason Tran, Nicholas Moscardelli, Krish Patel, Joshua Coren

Rowan-Virtua Research Day

Autoimmune pancreatitis (AIP), a manifestation of IgG4-related disease (IgG4-RD), is a rare, often misdiagnosed condition that can closely mimic pancreatic cancer, particularly in its clinical and radiographic presentation. We report the case of a 76-year-old retired plumber who presented with painless jaundice and was initially suspected to have pancreatic cancer based on imaging findings. Subsequent endoscopic evaluation, biopsy, and markedly elevated serum IgG4 levels led to a diagnosis of type 1 AIP. Treatment with corticosteroids resulted in rapid clinical improvement and reduction in IgG4 levels, confirming the diagnosis.

This case highlights the diagnostic challenges of AIP, especially among blue-collar workers …

A Ticking Time Bomb: An Overview Of A Case Report Of Neutropenic Fever Secondary To Tick-Borne Illness, Yasemin Galiboglu, Danielle Thor, Joann Ha, Kristine Wong, Cindy Hou

Rowan-Virtua Research Day

The advent of immunomodulatory therapies and their ever-expanding number of treatment indications necessitates the understanding of their associated complications. Neutropenic fever serves as an example of these complications often encountered in clinical practice. Although neutropenic fever can result from virtually any pathogen, episodes of the syndrome secondary to tick-borne illness remain relatively undocumented in the scientific literature. In the case presented, a 77-year-old female with a pertinent past medical history of smoldering IgG multiple myeloma on active immunosuppressive therapy presented with a first-time episode of neutropenic fever likely secondary to tick-borne illness. Through this overview of a broader report, attention …

Case Report: Pigtail Suprapubic Catheter Placement In A Patient With Acute Urinary Retention And Abdominal Mesh, Clara Keum, Zamran Masih, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Acute urinary retention (AUR) is a urological emergency that requires immediate bladder decompression and management of the underlying condition to prevent further complications such as urinary tract infection and renal failure. When standard urethral catheterization is not feasible, a suprapubic catheter can be used to achieve adequate bladder drainage. However, in patients with structural or anatomical challenges, such as the presence of surgical mesh, suprapubic catheter placement can be difficult. This case report presents the successful placement of an 8.5 French pigtail catheter and urinary drainage in an 86-year-old male with abdominal mesh who presented with AUR.

An Unusual Cause Of Sepsis: Capnocytophaga Canimorsus, Capnocytophaga, Christopher Dellmyer, Kishan B. Patel

Rowan-Virtua Research Day

Septic shock can be caused by numerous different pathogens. A few of the more common causes are Streptococcus Pneumoniae, Staphylococcus Aureus, Escherichia Coli, Pseudomonas Aeruginosa, and Candida Albicans. Although these are the pathogens involved in the majority of septic shock cases, it is imperative to take the entire clinical picture into account when treating a patient with septic shock. Here we will discuss a seemingly unimpressive dog bite leading to Capnocytophaga canimorsus bacteremia, septic shock and end organ failure.

Case Report: Haemophilus Influenzae Meningitis In A 65 Year Old Female, Kaywan Saed, Russell Mordecai

Rowan-Virtua Research Day

We report a case of a 65-year-old female who presented with fever, altered mental status, and neck stiffness. Cerebrospinal fluid (CSF) analysis confirmed Haemophilus influenzae meningitis. The differential diagnosis of bacterial meningitis in older adults is broad and includes Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, and Haemophilus influenzae. However, in the post-Hib vaccine era, non-typeable H. influenzae has emerged as a significant cause of invasive disease in older adults, particularly in those with underlying comorbidities.

Older patients often present with atypical symptoms, which may delay diagnosis and treatment. In this case, early recognition and prompt administration of empiric antibiotic therapy …

The Impact Of Emergency Room Overcrowding On The Incidence Of Healthcare-Acquired Infections Among Patients, Hayya Ali

Rowan-Virtua Research Day

Emergency department (ED) visits are vital components of healthcare delivery, serving as the primary site for acute medical care, particularly for individuals with urgent medical needs. The ED is among the most crowded hospital units. The fast-paced setting and over-crowdedness of an emergency room have become the reality of every hospital across the United States. Overcrowding causes problems for patients and staff, which include the risk of contracting healthcare-acquired infections. This is due to several factors that in most cases lead to an increase in the number of people within the ED, an increase in mortality and morbidity, and a …

Clinical Outcomes For Patients With Ventilator-Associated Pneumonia In Octogenarians, Nonagenarians, And Centenarians: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to examine the national inpatient sample data-base to describe in-hospital outcomes among patients over seventy who acquire ventilator-associated pneumonia after being on the ventilator for over 48 hours.

Assessing The Efficacy Of Prolonged Doxycycline Pep Use In High-Risk Populations For Sti Prevention, Lam Doan, Pearl Joslyn, Lizann Sung, Timothy Breiner, Sarah Marotta, Shikhar Rastogi

Rowan-Virtua Research Day

First recommended in October 2022, doxycycline post-exposure prophylaxis (DoxyPEP) has been increasingly used as a treatment for multiple sexually transmitted infections (STIs). To evaluate the efficacy of prolonged DoxyPEP use in high risk populations - men who have sex with men (MSM) and transgender women - for STIs, different sources addressing various aspects of DoxyPEP, its efficacy in STI prevention, and the potential consequences of its widespread use in terms of antimicrobial resistance were examined. Across 9 studies, DoxyPEP was found to decrease the incidence of bacterial STIs, specifically, syphilis, chlamydia, and gonorrhea with varying efficacy, especially for gonorrhea. Furthermore, …

The Role Of Myosin L In The Survival Of Toxoplasma Gondii And The Importance Of Mlc1 For In Vitro And In Vivo Myosin F Motility, Victoria K. Yi

Honors Scholar Theses

My thesis discusses the work that I have conducted on two myosins in Toxoplasma gondii, which is an obligate intracellular parasite that has chronically infected around 10% of the American population. It causes toxoplasmosis and severe health consequences for individuals with compromised immune systems or when infections occur in utero. However, immunocompetent individuals are asymptomatic or present with subclinical symptoms. In the Heaslip lab, I investigated two myosins in the parasite: Myosin L and Myosin F. MyoL is an uncharacterized motor that localizes at the apical end of the parasite. It was shown to be important for parasite …

In Vitro And In Vivo Evaluation Of The Effect Of A Commercial-Dried Enterococcus Faecium Fermentation Product As Quorum Sensing Inhibitors Of Salmonella Enterica Typhimurium, Ileana Loeza

Graduate Theses and Dissertations

The purpose of the present research was to evaluate Enterococcus faecium fermentation peptides (EFP) for antibacterial activity, inhibition of biofilm formation, and anti-quorum sensing properties against Salmonella Typhimurium (ST) in in vitro trials and individual body weight and ST organ colonization in therapeutic and prophylactic models in broiler chickens. Ninety-six day-of-hatch Cobb 500 broiler chickens were randomized and assigned to one of four treatments: NC) Negative Control, no EFP treatment and no ST challenge; NC+EFP) Negative Control, EFP treatment and no ST; PC) Positive Control, no EFP treatment and ST challenge, and PC+EFP) EFP treated and ST challenged. Independent trials …

Case Report: Cold Urticaria Diagnosed In The Emergency Department, Philip Carhart, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Cold urticaria can be primary (idiopathic) or can be due to underlying hematologic or infectious diseases. Here we present the case of a young female patient with no past medical history who was diagnosed with cold urticaria in the emergency department setting, using a cold stimulation test. Most cases are idiopathic. The reaction can be triggered in individual cases by exposure to cold objects or to generalized cold ambient temperatures, as was the case in the patient presented here. The physical response is most commonly pruritic wheals (urticaria). However, more severe symptoms may occur up to angioedema with hoarseness and …

Case Report: Dysphagia In Inclusion Body Myositis Leading To Respiratory And Gastrointestinal Complications, Veroneka Mikhail, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Inclusion body Myositis (IBM) stands as a rare and complex neuromuscular disorder (NMD) characterized by progressive muscle weakness and atrophy. Among its cardinal symptoms are dysphagia and respiratory distress, which are the most common cause of death in this disease. While the differential diagnosis of respiratory distress is vast and includes aspiration, pneumonia, acute coronary syndrome, emphysema, and congestive heart failure, a clinician should recognize that respiratory distress can also be secondary to dysphagia in NMDs like IBM and can quickly become life threating. Here we present the case of a 68-year-old female with a history of IBM who presented …

Case Report: Dissecting Retroperitoneal Abscess With Gas Formation, David F. Koziel Jr.

Rowan-Virtua Research Day

Presenting as a case to the emergency department was a 53-year-old male with a complaint of diffuse abdominal pain and focal right flank pain at site of recent percutaneous abscess drain site performed exactly one month prior. This followed hospitalization in the preceding year for complicated multifocal intra-abdominal infections requiring surgical interventions including exploratory laparotomy and surgical debridement for intra-abdominal abscess and scrotal abscess formation. Despite prior aggressive management and extensive coverage with broad-spectrum antibiotics, this patient was found to have fulminant recurrance of infection in the right retroperitoneal space with an expanding abscess dissecting through the retroperitoneal structures into …

‭Prevalence Of Potentially Pathogenic Bacteria In Showers At A Long-Term Nursing Care Facility, Joseph Caleb Kulon

Honors Theses

Pathogenic bacteria on environmental surfaces in nursing homes may contribute to the‬ growing burden of healthcare-associated infections (HAIs), particularly as the U.S. population‬ ages and more individuals transition into long-term care. In this study, 70 swab samples were‬ collected from five community shower rooms at a nursing home over three sampling trips. Five‬ common shower surfaces were sampled: the floor drain, shower bench, faucet/valves, shower‬ curtain, and grab bars. Samples were processed in the UTC CIDC microbiology lab and‬ inoculated onto four selective and differential media: Hardy CHROM MRSA agar (for‬ methicillin-resistant‬‭ Staphylococcus aureus‬‭ [MRSA]‬‭ and‬‭ S. pseudintermedius‬‭ [SIM]), mannitol‬ …

Bacterial Contamination Of Wheelchairs In A Long-Term Rehabilitation Facility, Storm A. Welch

Honors Theses

The presence of bacterial contamination on wheelchair surfaces in long-term care facilities poses a significant risk to infection control and patient safety. This study aimed to assess the prevalence and diversity of bacterial species, including Staphylococcus aureus (SA), methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis (SE), Pseudomonas spp., and enteric bacteria on five key components of wheelchairs at a local long-term care facility. A total of 320 swabs were collected from wheelchair components, including handles for pushing, armrests, seats, wheel handles, and tires. Samples were analyzed using selective culture media, and bacterial species were identified based on colony morphology. The results …

Expanding Inducible Epithelial Resistance Against Pneumonia: Novel Virus, Novel Receptor, Michael Longmire

Dissertations and Theses (Open Access)

Pneumonia is the leading infectious cause of death worldwide and presents a continuing risk among immunocompromised patients. Our work has been focused for many years on the phenomenon of inducible epithelial resistance, where activation of the innate immune response in the airway epithelium is necessary and sufficient to produce a pathogen-killing but self-protective environment to prevent severe disease. Inducible resistance is pathogen-agnostic and has been demonstrated against an array of respiratory infections. We achieve this using a combination of pattern recognition receptor agonists – Pam2CSK4 and ODN M362 being the current formulation – which produce synergistic levels of pathogen reduction …

Serological Evaluation For Leptospirosis On Samples Received By The Connecticut Veterinary Medical Diagnostic Laboratory (Cvmdl), Hayden R. Samuels

Honors Scholar Theses

Leptospirosis is a globally distributed zoonotic disease caused by pathogenic species of Leptospira, motile spirochetes capable of infecting humans and animals. Transmission typically occurs through contact with water or soil contaminated by the urine of reservoirs or infected animals. Although leptospirosis is considered a neglected tropical disease, its geographic range is expanding due to climate change and urbanization. Surveillance remains limited in many regions, especially in the United States. This study aimed to assess the seroprevalence and serovar diversity of Leptospira exposure in a variety of domestic and wild animals submitted to the Connecticut Veterinary Medical Diagnostic Laboratory (CVMDL). …

Exploring The Immunologic Consequences Of Atrx Deficiency In Glioma, Benjamin Whitfield

Dissertations and Theses (Open Access)

ATRX is a key chromatin regulator that is frequently mutated across multiple cancer types. One of the most common ATRX-mutated tumor types is the adult-type glioma, IDH-mutant, Astrocytoma. It is known that ATRX mutation leads to increases in DNA damage, replication stress, and global epigenetic regulation at a cell level; however, less is known about the impact of ATRX mutation on immune signaling. Furthermore, little is known about the interaction of ATRX loss with gain-of-function mutations in IDH. In this paper we set out to explore the impact of ATRX loss on immune signaling in gliomas, both in the context …

Assessing The Association Between Total Cholesterol And Hospitalized Myocardial Infarction In Women Ages 32-70: An Analysis Of The Framingham Heart Study, Jolene L. Stapleton Duree

Capstone Experience: Master of Public Health

Objective

Heart disease is the leading cause of death in women that may go undiagnosed due to unexpected symptoms. The purpose of this analysis was to assess the effect of total cholesterol on the odds of hospitalized myocardial infarction (MI).

Methods

This analysis used a sample of 2,445 women from the Framingham Heart Study, an observational prospective cohort study. The exposure was total cholesterol, and the outcome was hospitalized MI. Logistic regression was used to estimate crude and adjusted odds ratios (OR). The adjusted models controlled for age, blood pressure, and diabetes. Effect modification by diabetes status was evaluated in …

Host Genetics Role In Viral Disease Susceptibility, Christian Willis Eaton

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Viruses and their hosts exist in an evolutionary arms race, with evolutionary promotion of host genetic-based defense mechanisms and evolution of virus genetic-based mechanisms to overcome host defenses. Viruses are capable of much more rapid evolution and adaptation than their hosts, often leading to the use of host cellular mechanisms to promote viral infection and replication. In this study, we describe the generation of a detection assay for atypical porcine pestivirus (APPV), designed to target the viral 5’ UTR, a region of the viral genome which sees less mutations than the protein coding regions. This assay was generated to be …

Risk Factors Associated With Helicobacter Pylori Infection In The Urban Population Of China: A Nationwide, Multi-Center, Cross-Sectional Study, Liang Wang, Zheng Kang Li, Jin Xin Lai, Yu Ting Si, Jie Chen, Eng Guan Chua, Ling Yan Dai, Qiong Dai, Xu Bo Dai, Zhao Hui Deng, Hong Du, Qi Fang, Cui Feng, Min He, Guo Chu Hu, Yi Zhong Hu, Hui Huang, Yan Jiang Huang, Fen Li, Jun Hong Li, Qi Xin Li, Zhi Fang Lin, Hai Tao Liu, Ming Bo Liu, Jin Hua Luo, Jian Hong Ma

Research outputs 2022 to 2026

Objectives: To assess the risk factors associated with Helicobacter pylori infection in the urban Chinese population. Methods: The study was conducted from March to November 2023, including 12,902 urban participants aged 18-60 years across 52 cities distributed over 26 provinces in China. Risk factors included socioeconomic status, lifestyles, and public understanding. Univariate and multivariate logistic regression analysis was used to calculate corrected odds ratios (ORs) and 95% confidence intervals (CIs). Results: According to multivariate logistic regression, risk factors associated with significantly higher H. pylori infection rates included residency in developing (OR 1.27, 95% CI 1.13-1.43) and undeveloped cities (OR 1.15, …

The Infected Diabetic Foot: Bacteraemia And Endocarditis Complicating Moderate And Severe Foot Infections, Mario C Reyes, Arthur N Tarricone, Mathew J Sideman, Michael C Siah, Bijan Najafi, Edgar J G Peters, Lawrence A Lavery

Center on Aging Staff Publications

To identify the incidence of blood stream infections (BSIs) and endocarditis in patients with diabetic foot infections (DFIs), risk factors and clinical outcomes. A post hoc analysis of 280 patients using pooled patient level data from three RTCs. Blood cultures were drawn at time of admission for DFI. Deep intraoperative cultures were obtained from infected foot wounds. Data from the 12-month follow-up were used to determine clinical outcomes. 77.1% (N = 216) had blood cultures of which 15.7% (n = 34) had BSI. One patient (3.3%) had endocarditis. Risk factors for BSI included Charcot Neuroarthropathy history (20.6% vs. 7.1%, p …

Exploring The Non-Communicable Disease Burden In Indonesia – Findings From The 2023 Health Survey, Akifa Laila Rusyda

Indonesian Journal of Public Health Nutrition (IJPHN)

The present study rigorously examines the correlation between obesity, high-risk dietary consumption, and unhealthy lifestyles with the prevalence of non-communicable diseases (NCDs) in Indonesia. The study employed a cross-sectional study design using secondary data from the 2023 Indonesian Health Survey, analyzing 38 units (n) representing Indonesia's provinces in 2023. The correlation analysis, conducted using Pearson's test with a significance level of 95% (α<0.05), revealed significant regional disparities in the prevalence of NCDs, dietary consumption, and lifestyle factors across Indonesia. Moreover, the findings reveal a statistically significant positive correlation between obesity, high-risk food consumption, and lifestyle risk factors with the prevalence of several NCDs, including diabetes mellitus, heart disease, hypertension, and chronic kidney disease. These results underscore the potential impact of our research on public health in Indonesia. The results highlight also the urgent need for targeted public health initiatives, such as policies promoting healthier food choices, controlling the food environment, encouraging physical activity, and supporting smoking cessation to mitigate the growing burden of NCDs in Indonesia.

Optimization Of Reaction Conditions For Synthesizing Kasa-Targeting Drug Candidates For Tuberculosis Treatment, Megan A. Baxter

Research and Creativity Symposium

Tuberculosis (TB) remains a global health challenge, with increasing drug resistance pressing for the development of novel treatments. KasA, a key enzyme in mycobacterial fatty acid biosynthesis, is a promising drug target for TB treatment. This research focuses on the design and synthesis of potential KasA inhibitors, specifically optimizing reaction conditions to efficiently produce 1-methyl-6-aminoindazole. This molecule is an intermediate in the synthesis of drugs targeting TB. Characterization of synthesized compounds is performed using NMR, mass spectrometry, and gas chromatography to confirm structure and purity. The first step involved optimizing the solvent and base for the methylation of nitroindazole. We …

Use Of Procalcitonin In Therapeutic Decisions In The Pediatric Intensive Care Unit, Pierre Tissières, Elisabeth Esteban Torné, Johannes Hübner, Adrienne Randolph, Corsino Rey Galán, Scott Weiss

Department of Medicine Faculty Papers

Procalcitonin (PCT) is frequently used by clinicians in children with suspected bacterial infections and sepsis. However interpretation in the critically ill child may be challenging due to the complexity of underlying conditions and its impact on PCT values. Herein, we propose a guidance for the use of procalcitonin in critically ill children, supported by a comprehensive analysis of the literature, to help the clinician for interpreting PCT in the various clinical conditions encountered in pediatric intensive care units. We describe the importance of the clinical context, timing of measurement and evidence on PCT values in diagnosing sepsis and to guide …

The Effects Of Cyclic Peptide [R4w4] In Combination With First-Line Therapy On The Survival Of Mycobacterium Avium, Melissa Kelley, Kayvan Sasaninia, Ali Badaoui, Ira Glassman, Arbi Abnousian, Nadia Rai, Rakesh K. Tiwari, Vishwanath Venketaraman

Pharmacy Faculty Articles and Research

Background: Mycobacterium avium (M. avium) is a nontuberculous mycobacterium (NTM) that can cause pulmonary and extrapulmonary infections mostly in immunocompromised individuals, such as those with HIV and diabetes. Traditionally, rifampicin (RIF) and azithromycin (AZ) have been used for a 12-month duration as first-line antibiotics against M. avium. Due to the increased multidrug resistance, novel ways, such as enhancement of macrophages response, are needed to provide adequate immune response required to clear M. avium infection.

Methods and findings: In this study, we aim to study the effects of using THP-1 cells, which are monocyte-like cells, to induce a …

Evolution Of The Tumor Immune Landscape During Treatment With Tebentafusp, A T Cell Receptor-Cd3 Bispecific, Joseph Sacco, Peter Kirk, Emma Leach, Alexander Shoushtari, Richard Carvajal, Camille Britton-Rivet, Sophie Khakoo, Laura Collins, Luis De La Cruz-Merino, Zeynep Eroglu, Alexandra Ikeguchi, Paul Nathan, Omid Hamid, Marcus Butler, Sarah Stanhope, Koustubh Ranade, Takami Sato

Department of Medical Oncology Faculty Papers

Metastatic uveal melanoma is an aggressive disease with poor outcome, which is refractory to immune checkpoint inhibitors. A T cell receptor (TCR)-based CD3 bispecific, tebentafusp, delivers clinical benefit in patients with metastatic uveal melanoma. Understanding the molecular basis for the anti-tumor activity of tebentafusp in an indication where checkpoint inhibitors are ineffective could aid in identification of other solid tumor indications where CD3 bispecifics may serve an unmet need. By analyzing tumor biopsies taken prior to treatment, early on-treatment, and at progression (NCT02570308), using RNA sequencing (RNA-seq) and immunohistochemistry (IHC), we show that expression of interferon-related genes in the tumor …

Nanopore Sequencing For The Detection And Preliminary Identification Of Viruses In Amblyomma Americanum L. (Acari: Ixodidae), Mary Katherine Humphrey, Lorenza Beati, Ella Zierdt, Saviour Dralabu

Honors College Theses

Hard-bodied ticks are known to carry a wide range of viruses, some of which can cause human diseases. In the U.S., the tick Amblyomma americanum is an important disease vector. The tick has recently expanded its distribution range and its abundance is rising in many areas of the U.S. Its virome is, however, largely underexplored. In this preliminary study, we used a Nanopore MinION sequencer to detect and identify the viral fauna in nymphal ticks (n=43) collected in Statesboro, GA. Extracted DNA and RNA were analyzed separately. Nucleic acids were pooled into 6 groups according to their collection dates and …

Primary Place To Go For Health Care And Its Association With Hpv Prevalence In Us Adults: Results From Nhanes 2013-2016, Amy L. Mcveety, Miyuki Sun

OHSU-PSU School of Public Health Annual Conference

Background: While access to health care is a known risk factor for many infectious diseases, including sexually transmitted infections, little research has investigated the relationship between access to primary care services and prevalent human papillomavirus (HPV) infection. Given HPV’s prevalence in the general population and lack of available treatments, it is necessary to understand possible risk factors to identify areas for intervention. This study uses primary place to go for health services as a proxy measure for access to care, in order to understand which sources of health care are serving patients with the highest prevalence of HPV infections and …

Clinical Characteristics And Outcomes Of Pediatric Staphylococcal Scalded Skin Syndrome (Ssss) At An Inner-City Tertiary Care Center, Nina Kb Gust Md, Ashley Frei Bs, Rebecca M. Adams Bs, Elika Ridelman Phd, Christina Shanti Md, Ronald Thomas Phd, Jocelyn Y. Ang Md

Medical Student Research Symposium

Introduction

Staphylococcal Scalded Skin Syndrome (SSSS) is a blistering skin condition caused by a toxin-producing staphylococcus species. Epidemiologic studies on pediatric SSSS in the United States are limited, with a reported incidence of 7.67 cases per million children and 45.1 per million infants. Immature renal function, lack of protective antibodies, and increased exotoxin target desmoglein-1 are hypothesized to increase incidence in younger children. We aimed to determine clinical and microbiological characteristics of pediatric SSSS and factors that could help predict disease severity.

Methods

A retrospective chart review was performed for admitted patients under 18 years old diagnosed with SSSS from …